TNF and chronic kidney disease: It has also been shown that some proinflammatory markers, such as IL-1β, tumor necrosis factor alpha (TNF-α), and lipopolysaccharide (LPS), stimulate the production of FGF23, which in turn perpetuates the progression of CKD, creating a vicious cycle [21]. Figure 2 summarizes the effect of FGF23 on CKD.