Ali Mohammed Hadi^1,2, Jubran K Hassan¹, Qutaiba A Qasim³ , Kadhim Ali Kadhim⁴

¹Department of Clinical Pharmacy, College of Pharmacy, University of Basra; ²Department of Clinical Pharmacy, College of Pharmacy, University of Al-Kunooze; ³Department of Clinical Laboratory Sciences, College of Pharmacy, University of Basra, Basra; ⁴College of Medicine, University of Baghdad, Baghdad, Iraq.

For correspondence:-  Qutaiba Qasim   Email: qutaiba.qasim@uobasrah.edu.iq

Received: 5 June 2026        Accepted: 19 September 2026        Published: 30 September 2026

Citation: Hadi AM, Hassan JK, Qasim QA, Kadhim KA. Integrated clinical pharmacy and clinical biochemistry in optimizing drug therapy and biomarkers in patients with chronic kidney disease. Trop J Pharm Res 2026; 25(9):1267-1273 doi: tjpr.v25i9.10

© 2026 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To investigate the role of an integrated clinical pharmacy and clinical biochemistry model in improving medication safety and biomarker profiles in adults with chronic kidney disease (CKD) compared with usual nephrology care in Iraq.

Methods: This study was a controlled trial in which 80 adults with CKD (stages 3-5) were randomized into an integrated intervention (study group) or conventional care program (control group). The follow-up period lasted for 6 months. This intervention involved pharmacist-led medication review, renal dose optimization, drug-related problems (DRPs) resolution, adherence support, protocol-based monitoring, and interdisciplinary interpretation of renal and biochemical markers. Primary (mean DRPs per patient, rates of renally cleared medicines) and secondary outcomes (estimated glomerular filtration rate (eGFR), key biochemical parameters, adherence, and drug-related hospitalisations) were compared.

Results: A total of 80 patients were randomized into study and control groups (n = 40). Study group showed no significantly lower mean DRPs per patient compared to control group (p > 0.05). Furthermore, appropriate renal dosing significantly increased in study group compared to control group (p < 0.001). Mean change in eGFR was significantly lower in study group (p < 0.05), with more stable potassium and phosphate levels, fewer serious DRPs and drug-related hospitalisations and better adherence scores.

Conclusion: Integrating clinical pharmacy and clinical biochemistry into CKD outpatient management improves medication safety and stabilizes renal and biochemical parameters

Keywords: Biomarkers, Chronic kidney disease, Clinical biochemistry, Clinical pharmacy, Drug-related problems

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