Pathomechanical Models of Vertebral Compression, Hyperuricemia and Nephrotoxicity: Intersection between Traumatology, Rheumatology and Nephrology in Multiple Myeloma
DOI:
https://doi.org/10.70577/asce.v5i1.598Keywords:
Multiple Myeloma, Vertebral Compression, Hyperuricemia, Nephrotoxicity, Interdisciplinary.Abstract
Multiple myeloma is a complex hematological neoplasm that disrupts various organ systems, with bone and renal complications exerting profound effects on prognosis and patient quality of life. This review and retrospective analysis integrate the pathomechanical models of vertebral compression, hyperuricemia, and nephrotoxicity, proposing an interdisciplinary approach for comprehensive care. A cohort of 81 patients with multiple myeloma was examined, documenting a high prevalence of pathological vertebral fractures (48.2%), frequent hyperuricemia (55.5%), and nephrotoxicity (44.4%). The study demonstrates that the release of pro-inflammatory cytokines and factors such as RANKL accelerates bone resorption, leading to hypercalcemia and vertebral instability. Elevated nucleotide catabolism, both tumor-driven and therapy-induced, raises serum uric acid levels, promoting crystal formation and subsequent tubular renal injury. A strong correlation was observed between the simultaneous appearance of these complications, highlighting the need for vigilant monitoring and anticipatory strategies. The multidisciplinary team is crucial in reducing mortality through early intervention and collaborative management between traumatology, rheumatology, and nephrology. This comprehensive pathomechanical model enhances risk stratification and the application of targeted therapies, providing a foundation for future research focused on preventive and personalized interventions that mitigate the multisystem damage characteristic of multiple myeloma.
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Copyright (c) 2025 Jenny Clarivel Barahona Pilco, Bryan Alexander Godoy Bastidas, José Andrés Viteri Herrera, Santiago Daniel Zamora Larreategui, José Roberto Lema Balla
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