Abstract
<title>Abstract</title> <p>Background Platinum-based agents (cisplatin, carboplatin, and oxaliplatin) are essential in the treatment of solid tumors, but they are associated with nephrotoxicity. Acute kidney injury (AKI) occurs most frequently with cisplatin and can lead to treatment delays, dose reduction, or discontinuation, as well as increasing the risk of renal adverse events and mortality. In Latin America, evidence on incidence, associated factors, and outcomes is limited. Aims To estimate the frequency of platinum-induced chemotherapy nephrotoxicity, describe the clinical characteristics, and determine the renal and clinical outcomes in adults with solid tumors. Methods A retrospective, analytical cohort study was conducted on patients aged 18 years or older diagnosed with any solid tumor who had received at least one cycle of platinum-based chemotherapy over a 5-year period. Acute kidney injury was defined and classified according to the KDIGO 2026 criteria. Demographic variables, comorbidities, baseline renal function, electrolyte imbalances, exposure to nephrotoxic agents, tumor type, treatment regimen, and cumulative dose were collected. The frequency of nephrotoxicity by drug was estimated, and outcomes such as renal recovery, need for renal replacement therapy, regimen modifications/discontinuation, and mortality were explored. Results A total of 114 patients were included in the study. Testicular cancer was the most frequent neoplasm (29.8%). Acute kidney injury occurred in 31.6%, while electrolyte imbalances were documented in 35.1% of patients. Renal replacement therapy was required in 7.9%, and 7.0% developed chronic kidney disease. Treatment discontinuation occurred in 7.0% of the study population, while dose modification was necessary in 11.4%. Overall mortality was 1.8%. Conclusions Platinum exposure itself remains a determinant of nephrotoxicity, even in patients traditionally considered to have a relatively low renal risk. These observations suggest that the clinical burden of platinum nephrotoxicity extends far beyond short-term increases in serum creatinine, directly influencing renal and oncological outcomes. This represents the first study published in Mexico and the second in Latin America.</p>