TNF and nutritional deficiency disease: Blood purification treatment in patients with ESRD may be associated with varying degrees of micro inflammation, leading to malnutrition, anemia, and increased risk of cardiovascular disease.21,22 Studies show that accumulation of IL-6, hs-CRP and TNF -α is associated with continuously aggravated microinflammatory state, endothelial damage, oxidative stress, and higher risk of cardiovascular atherosclerosis.22,23