Establishment of Reference Ranges for Biochemical Parameters in Children and Adolescents of Ages 1-17 Years in Meru County, Kenya
Kainyu, Munene Rhoda
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Clinical Biochemistry (Clinical Chemistry/Chemical Pathology) is the study of the biochemical basis of disease, and the application of biochemical and molecular techniques in diagnosis. An understanding of the biochemical mechanisms of disease provides modern medicine with a rational basis for diagnosis and therapy. A reference range is a set of values used by a health professional to interpret a set of medical test results. The range is usually the set of values in which 95% of the normal population falls. Clinical chemistry reference ranges vary due to factors such as age, sex, diet, race, climate, altitude and genetics. As a result, International Federation of Clinical Chemistry (IFCC) recommends that every laboratory establishes its own reference intervals for biochemical parameters and not rely on those obtained from a different population. There is little information in the literature on biochemical reference values for children in Kenya and in particular those from Meru County. This study was aimed at determining age and sex-based reference ranges for thirteen routinely analyzed biochemical parameters for liver and renal function for the children population in Meru County. This was a population based cross-sectional study carried out at the Meru Level Five Hospital. 768 healthy males and females were recruited in this study and only 740 whose serum samples tested negative for HIV, hepatitis B, syphilis were used in the final analysis; 380 males and 360 females. 28 samples were excluded, out of which 6 were HIV positive and 22 " It were hemolyzed. DRI-CHEM NX 500r Clinical Chemistry analyzer (Fujifilm, t Europe) was used to analyze thirteen clinical chemistry parameters, including serum proteins, bilirubin, tissue enzymes and electrolytes. Clinical and Laboratory Standards Institute (CLSI) guidelines were followed to create study consensus intervals. Determination of reference ranges was done in order to estimate the lower 2.5 and upper 97.5 percentiles of distribution by use of parametric methods. The determined percentiles were considered as the lower and upper reference limits respectively. There were significant differences in relation to sex in children reference values for potassium (p = 0.009), total protein (p = 0.039) and sodium (p = 0.003). Other parameters did not"show significant differences across the age groups and by gender. In conclusion, the findings of this study provide sex and age specific reference range values for children from Meru County in Kenya. From the study findings, recommendation is made to health care practitioners and facilities in Meru County to adopt the new reference values developed, particularly for the three parameters that exhibited significant differences in sex and for. other regions in Kenya to carry out a similar study to determine their own reference values.