TNF and stage 5 chronic kidney disease: A recent meta-analysis of cross-sectional associations found significantly higher levels of pro-inflammatory biomarkers, C-reactive protein, interleukin 6 (IL-6), and tumor necrosis factor-alpha, and significantly lower levels of the anti-inflammatory cytokine IL-10 in CKD and end-stage renal failure patients with depressive symptoms relative to CKD and end-stage renal failure patients without depressive symptoms (28).