TNF and chronic kidney disease: It has been reported that CKD upregulates GPR68 expression in monocytes and enhances the secretion of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6), thereby promoting inflammatory signaling and, under certain conditions, amplifying systemic inflammation and cardiac fibrosis (Sarakpi et al., 2023; Yoshida et al., 2021).