الفهرس 
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Abstract
Diabetic nephropathy is a common and serious complication of T2DM associated with adverse outcomes of cardiovascular disease, and premature mortality and is one of the leading causes of ESRD.
The etiology of DN is multi-factorial which includes the cooperation between both environmental and genetic factors because not all diabetic subjects with traditional risk factors develop clinically evident nephropathy, indicating a role for individual susceptibility. Hence identification of risk genes will aid in understanding the pathogenesis of the disease and could also serve as a powerful tool for identifying the subset of T2DM patients towards the progress of DN facilitating earlier intervention that could prevent or postpone the occurrence of diabetic nephropathy.
A number of genes have been suggested as diabetic nephropathy candidate genes including tumor necrosis factor- α.TNF-a is a pro-inflammatory cytokine involved in the regulation of immune cells and plays an important role in the pathogenesis of many types of diseases.
A number of polymorphisms in the TNF-α gene especially in the promoter region have been identified and linked to risk of different autoimmune and inflammatory diseases. It has been well determined that TNF-α plays a pivotal role in the pathogenesis of DN. Accordingly SNPs in the promoter region of TNF-α gene may increase the risk of DN. However very little studies had examined the association between TNF-α promoter polymorphisms at position -863C/A and -1031T/C and DN.
The current study aimed at investigating the association between -863C/A (rs1800630) and -1031T/C (rs1799964) polymorphisms in TNF- α gene with DN among subjects with T2DM.The study included 2 matched groups; 40 type 2 diabetic patient without DN and 40 type 2 diabetic patients with DN.