TNF and metabolic syndrome: Since patients with NAFLD exhibit multiple traditional and non-traditional risk factors (e.g. metabolic syndrome, increased C-reactive protein, interleukin-6, tumor necrosis factor-α levels and other acute-phase proteins, and so on) for CKD 33-35, it is not surprising that these patients also have a higher prevalence and incidence of CKD compared with those who do not have steatosis.