Qutaiba A Qasim¹, Ali Mohammed Hadi², Kadhim Ali Kadhim³ , Hany Akeel Al_Hussaniy^3,4

¹Department of Clinical Laboratory Sciences; ²Department of Clinical Pharmacy, College of Pharmacy, University of Basra, Basra; ³Department of Clinical Pharmacy, College of Pharmacy, Mustansiriyah University, Baghdad; ⁴Department of Pharmacology, College of Pharmacy, Al-Nisour University, Baghdad, 5Dr Hany Akeel Institute, Iraqi Medical Research Centre, Baghdad, Iraq.

For correspondence:-  Kadhim Kadhim   Email: Kadhim.a@comed.uobaghdad.edu.iq

Received: 10 January 2026        Accepted: 19 March 2026        Published: 30 March 2026

Citation: Qasim QA, Hadi AM, Kadhim KA, Al_Hussaniy HA. Comparative evaluation of renal function in patients using different antihypertensive drug classes. Trop J Pharm Res 2026; 25(3):373-382 doi: https://dx.doi.org/10.4314/tjpr.v25i3.10

© 2026 The authors.
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Abstract

Purpose: To compare renal function in hypertensive adults treated with antihypertensive drug classes in a tertiary private clinic in Basra, Iraq. Method: A retrospective cohort comprised 450 adults with hypertension on stable therapy for 6 months from January 2024 to December 2025 in Al-Fayhaa Teaching Hospital, Basra, Iraq. Five monotherapy groups (60 patients each): angiotensin converting enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB), calcium channel blocker (CCB), β-blocker, diuretic, and combination therapy (150 patients) comprising any two or more antihypertensive medications. Demographic and laboratory data were obtained. Analysis of variance and the Kh2 test were used to compare estimated glomerular filtration rate (eGFR), serum creatinine, and urine albumin-creatinine ratio (UACR). Results: The highest mean eGFR occurred in ACE-inhibitor and ARB-groups, and the lowest mean eGFR in β-blocker and diuretic groups. Non-RAAS monotherapy groups (Group 3 (calcium channel blockers), Group 4 (beta blockers)) were more common in terms of chronic kidney disease (CKD; eGFR < 60 mL/min/1.73 m2) and moderate-to-severe albuminuria. Diuretic and β-blocker monotherapy were associated with lower eGFR and a twofold increase in the odds of CKD and albuminuria in comparison with ACE inhibitor therapy after confounder adjustment. Still, ARB and RAAS-combination therapy had renal profiles comparable to ACE inhibitor therapy. Conclusion: The RAAS-blocking regimens comprising ARB and ACE inhibitors were associated with more favorable renal outcomes than non-RAAS monotherapies (CCB, β-blocker, and diuretic), supporting the prioritization of ACE inhibitors or ARBs as first-line therapy in hypertensive patients at renal risk.

Keywords: Albuminuria, Angiotensin receptor antagonists, Antihypertensive agents, Glomerular filtration rate

Impact Factor
Thompson Reuters (ISI): 0.6 (2023)
H-5 index (Google Scholar): 49 (2023)