Kidney failure is associated with chronic inflammation and with a striking increase in the risk of cardiovascular diseases, like heart attacks and strokes, by poorly understood mechanisms. Prof Hans-Joachim Anders, RELENT partner at Ludwig-Maximilians-Universität München, led an international collaboration to shed light on this conundrum. By studying mice and analysing the blood of more than 1900 people, they showed that levels of catepsin-S increase in parallel with reduced kidney function. Catepsin-S is a protein released by activated immune cells that has already been implicated in the pathogenesis of cardiovascular disease. This study, published in Scientific Reports, suggests that catepsin-S might be a novel therapeutic target to prevent cardiovascular disease in the setting of poor kidney function.