Chronic kidney disease--mineral bone disorder (CKD-MBD) is a complex syndrome influenced by various factors, such as age, CKD etiology, uremic toxins, and dialysis modality. Although extensively studied in hemodialysis (HD) patients, only a few studies exist for peritoneal dialysis (PD) patients. Since most of these older studies contain no bone biopsy data, we studied the pattern of renal osteodystrophy in 41 prevalent PD patients. The most common presentation was adynamic bone disease (49%). There was a significant inverse association between serum sclerostin (a Wnt/β-catenin pathway inhibitor that decreases osteoblast action and bone formation) and the bone formation rate. Bone alkaline phosphatase had the best sensitivity and specificity to detect both high- and low-turnover diseases. The comparison between nondiabetic PD and HD patients, matched by age, gender, parathyroid hormone level, and length of dialysis, revealed low 25-hydroxyvitamin D levels, worse bone mineralization, and low bone turnover in the nondiabetic PD group. Thus, adynamic bone disease was the most frequent type of renal osteodystrophy in PD patients. Sclerostin seems to participate in the pathophysiology of adynamic bone disease and bone alkaline phosphatase was the best serum marker of bone turnover in these patients.

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Renal dysfunction seen in patients with American cutaneous leishmaniasis (ACL) has been attributed to the use of antimonials for treatment. To determine whether ACL itself causes tubular dysfunction, we measured renal function in 37 patients with ACL prior to their treatment and compared results to that in 10 healthy volunteers of similar mean age. None of the patients presented with glomerular dysfunction; however, 27 had a urinary concentrating defect. There was no statistical difference between groups in the pre- and post-desmopressin test of urine osmolality, but the post-test urine osmolality of the controls was significantly higher. Urinary AQP2 levels, determined by western blot of isolated exosomes, were found to be significantly lower in patients than in controls, whereas that of the cotransporter (NKCC2) was significantly higher. A urinary acidification defect (post-test pH greater than 5.50 following calcium chloride) was found in 15 patients. Pretest plasma bicarbonate was below normal in 12 patients as was the pretest plasma pH in 14. Expression of the Na/H exchanger (NHE3), H(+)-ATPase, and pendrin were all significantly higher in patients with ACL than in controls. A combined urinary concentration and acidification defect was found in 12 patients. Thus, the urinary concentrating defect of ACL may be caused by decreased AQP2, with increased NKCC2 compensatory. Pendrin upregulation may be related to the urinary acidification defect with increased NHE3 and H(+)-ATPase also compensatory. Hence, ACL can cause asymptomatic renal tubular dysfunction.

RESUMO: Utilizando a técnica de hidrodestilação, usando um adaptador Clevenger, foram extraídos óleos essenciais das espécies Pimenta dioica (folhas e frutos) e Syzygium aromaticum (botões florais, talos e folhas). A composição química dos óleos foi determinada através da analise CG-EM. Os teores de óleos essenciais variaram de 0,97 a 1,41% e 2,30 a 15,40% nas espécies Pimenta dioica e Syzygium aromaticum, respectivamente. O componente majoritário presente nessas espécies foi o eugenol, variando de 72,87 a 90,41%. Syzygium aromaticum forneceu maior teor de óleo essencial rico em eugenol. Em quantidades menores foram também encontrados chavicol e β-cariofileno.Unitermos: Syzygium aromaticum, Pimenta dioica, Myrtaceae, eugenol, Brasil, óleo essencial.ABSTRACT: "Volatile chemical constituents of rich spices in eugenol". Essential oils were extracted from the leaves and fruits of Pimenta dioica and leaves, stalks and floral buttons from Syziguim aromaticum by hydrodistillation using a Clevenger apparatus. The essential oil compositions were determined by CG-MS analyses. The yield varied from 0.97 to 1.41% and from 2.30 to 15.40% in the P. dioica and S. aromaticum, respectively. In both species the major component was the eugenol, varied from 72.87 to 90.41%, being richer the essential oil extracted from S. aromaticum. Chavicol and β-caryophyllene were identified in low percentage.