Reference Ranges for Biochemical Parametres,Creatinine,Clearance,Oral Glucose Tolerance Test,Lipids,Tumour Markers and Hormones for Adult Kenyans
Waithaka, Stanley King'e
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Cliniccahl emistryreference ranges vary due to factors such as age, sex, race, diet, climate, altitudgee,netics,geographical location, instruments, analytical methods, and sample type. Due to this,International Federation of Clinical Chemists recommends that each laboratory establisheitss own references ranges for the biochemical parameters and not rely on the Manufacturerre'sference range values. There is little information in the literature on biochemical referenvcaeluesfor adult Kenyans. The aim of this study was to determine age, sex, and region basedreferenceranges for 45 biochemical parameters for the adult Kenyans. This was a populatiobnased cross-sectional prospective study carried out at Kenyatta National Hospital. 6768participants(3389 males and 3379 females) from the eleven counties were used in the establishmeonft reference, ranges for 45 biochemical parameters. Reference ranges were constructeudsing parametria methods to estimate 2.5 and 97.5 percentiles of distribution as lower andupper reference limits, respectively. The performance of manual spectrophotometer wasassessedby comparing levels of total protein, albumin, total bilirubin, and alkaline phosphatausseing autoanalyzer as the gold standard. Results show that some of the established referencraengeswere sex and age specific, and were different from American, Germany and French basedreference ranges used in Kenyan hospitals, except for calcium which was similar. Glucosaend uric acid showed significant regional differences. Results of the selected analyte determineudsing the manual spectrophotometric method were significantly lower than those obtaineudsingthe automated analyzer. In conclusion, the findings of this study provide adult sex, age,and region specific reference range values to be used in Kenya; it also shows that automatemdethodsare superior to the manual methods in determining analyte levels. In view of thedifferences in reference ranges of the study population and of the others quoted in literature, it is importantthat clinical laboratories should establish their own biochemical parameter referencraengesbased on the population they serve. Due to age and sex differences expressed in thisstudy,there is need to consider thes~ two factors whenever test requisition is made and duringthe construction of reference rairg~sJor other biochemical parameters. There is great needto revolutionize the analytical methods by replacing manual methods with automated methodinsall c1inicallaboratories.