TNF and glomerulosclerosis: Podocyte apoptosis can lead to proteinuria and glomerulosclerosis in DKD [64], with two pathways, namely, the extrinsic pathway (centered on extracellular ligands such as tumor necrosis factor - TNF) and the intrinsic pathway (centered on mitochondria-mediated mechanisms) identified as contributors to podocyte apoptosis [65].