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Background/Aims: To explore the relationship between hydrogen sulfide (H₂S) 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 H₂S was measured with a sulfide sensitive electrode. Results: Plasma H₂S in CHD/DN was significantly lower than that in CHD/non-DN patients. Plasma H₂S 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 H₂S levels than in CHD/non-DN patients. Moreover, in CHD/DN patients, CCA-IMT was negatively correlated with plasma H₂S, and positively correlated with hsCRP and LDL. On multiple regression analysis, H₂S …