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

Abstract

Cisplatin-induced nephrotoxicity is a frequent and underdiagnosed complication in oncology patients. This retrospective, observational and descriptive study aimed to determine the prevalence of subclinical renal damage in patients treated with cisplatin at SOLCA Cuenca Hospital between 2020 and 2024, using traditional biomarkers, and to establish an epidemiological basis for future research on urinary biomarkers. We analyzed 281 clinical records of adult patients, evaluating serum creatinine, estimated glomerular filtration rate (eGFR) and urea. Subclinical renal impairment was defined as an increase in creatinine above 0.9 mg/dL in women and 1.2 mg/dL in men. Subclinical renal damage after treatment was found in 11.74% of patients. No statistically significant association was found (p < 0.05; Fisher's exact test) with variables such as dose, duration of treatment, age, sex or body mass index (BMI). Creatinine increased on average from 0.89 to 1.09 mg/dL, and eGFR decreased from 78.14 to 61.01 mL/min/1.73 m²; urea levels remained stable. The results show that traditional biomarkers can detect overt subclinical renal damage, although they have limitations for early detection. Therefore, it is recommended to implement emerging urinary biomarkers such as KIM-1 (kidney injury molecule-1), NGAL (neutrophil gelatinase-associated lipocalin), L-FABP (liver-like fatty acid binding protein), IL-8 (interleukin 8) and urinary transferrin. This study provides a relevant epidemiological basis and highlights the need for prospective research to improve renal monitoring in cancer patients treated with cisplatin.