Correlation of Lower Concentrations of Hydrogen Sulfide with Atherosclerosis in Chronic Hemodialysis Patients with Diabetic Nephropathy

Background/Aims: To explore the relationship between hydrogen sulfide (H 2 S) and uremic accelerated atherosclerosis (UAAS) in chronic hemodialysis patients with diabetic nephropathy (CHD/DN). Methods: A total of 36 CHD/DN and 32 chronic hemodialyzed non-diabetic patients with chronic glomerulonephritis (CHD/non-DN) were studied. Plasma H 2 S was measured with a sulfide sensitive electrode. Results: Plasma H 2 S in CHD/DN was significantly lower than that in CHD/non-DN patients. Plasma H 2 S was positively correlated with plasma TGF-β1, and negatively correlated with MMP-12 in CHD/DN patients. CHD/DN patients exhibited higher CCA-IMT, hsCRP, and lower H 2 S levels than in CHD/non-DN patients. Moreover, in CHD/DN patients, CCA-IMT was negatively correlated with plasma H 2 S, and positively correlated with hsCRP and LDL. On multiple regression analysis, H 2 S levels exhibited independent association with IMT in CHD/DN patients. Conclusions: These findings suggest possible linkage between H 2 S metabolism and TGF-β/Smad signaling pathway modulation abnormalities that may contribute to the development of UAAS in CHD/DN patients.