Evaluación retrospectiva del daño renal en pacientes oncológicos tratados con Carboplatino: análisis de biomarcadores tradicionales como base para el estudio de un panel de biomarcadores urinarios de daño renal subclínico

Abstract

Carboplatin, a chemotherapeutic agent used in the treatment of various neoplasms, has been associated with renal toxicity. Within the framework of an academic collaboration between the University of Cuenca (Ecuador) and the University of Salamanca (Spain), and as part of the doctoral thesis training process of the PhD Program in Pharmacy and Health, this study was conducted with the objective of determining the prevalence of renal impairment in oncology patients treated with carboplatin. To this end, a database was constructed using medical records from 280 patients at the SOLCA-Cuenca Oncology Institute during the period 2020–2024. Renal biomarkers such as urea, creatinine, and estimated glomerular filtration rate were reviewed, along with demographic, clinical, and comorbidity-related variables. The findings revealed that 5.35% of patients developed possible subclinical renal damage, with a statistically significant association with the administered dose (p-value = 0.003). Additionally, the predictive power of clinical variables and comorbidities in relation to potential renal damage was assessed. It was found that treatment duration and the presence of arterial hypertension exhibited relative importance as predictors of renal function deterioration (with decreases in accuracy of 4.65 and -7.23, respectively, in the Random Forest analysis). These results highlight the importance of individualized dose adjustment, as well as the clinical relevance of concomitant pathologies in oncologic management. Furthermore, the findings establish an epidemiological foundation that will be useful for future research, particularly regarding emerging biomarkers.