Hydrogen sulfide, H2S, is the third endogenous gas with cardiovascular properties (the others are nitric oxide and carbon monoxide). In fact, among other important signaling functions, H2S plays a key role in regulating blood pressure. Cystathionine ß-synthase, cystathionine γ-lyase (CSE) and 3-mercaptopyruvate sulfurtransferase are the principal enzymes devoted to H2S formation. We have recently shown that H2S levels are decreased in patients on chronic hemodialysis through the transcriptional deregulation of the CSE gene, hinting at the possibility that a link exists between this finding and hypertension and the high cardiovascular mortality typical of these patients.