Hydrogen Sulfide, the Third Gaseous Signaling Molecule With Cardiovascular Properties, Is Decreased in Hemodialysis Patients

Hydrogen sulfide, H 2 S, is the third endogenous gas with cardiovascular properties, after nitric oxide and carbon monoxide. H 2 S is a potent vasorelaxant, and its deficiency is implicated in the pathogenesis of hypertension and atherosclerosis. Cystathionine β-synthase, cystathionine γ-lyase, and 3-mercaptopyruvate sulfurtransferase catalyze H 2 S formation. Chronic kidney disease is characterized by high prevalence of hyperhomocysteinemia, hypertension, and high cardiovascular mortality, especially in hemodialysis patients. H 2 S levels are decreased in hemodialysis patients through transcriptional deregulation of genes encoding for the H 2 S-producing enzymes. Potential implications relate to the pathogenesis of the manifestations of the uremic syndrome, such as hypertension and atherosclerosis.