TNF and medical procedure: Among the 22 significantly upregulated pathways in the AAN group, pathways such as epithelial-mesenchymal transition (EMT), P53 pathway, and TNF-α signaling via NF-κB, apoptosis, and IFN-γ response have been reported to correlate with renal epithelial cell damage or fibrosis, leading to classic kidney injury model formation and development (37–41).