The establishment of reference ranges for some biochemical parameters for the adult Kenyan population at Kenyatta National Hospital
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Date
2003-10
Authors
Waithaka, Stanley King'e
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Abstract
Reference ranges are used by the health providers in the interpretation of
clinical laboratory results. Age, sex, diet and geographical location of the
patient affect these reference ranges. Most clinical laboratories use reference
ranges quoted in literature or the reagent kits for the interpretation of
laboratory results. In view of this, the current prospective study undertook the
construction of reference ranges for the routinely analyzed biochemical
parameters, and at the same time established the effect of sex and age on the
constructed reference ranges for the Kenyan adult population. End point and
enzymatic rate of reaction analytical methods were used in the automated
clinical chemistry analyzers. The concentrations of 12 biochemical analytes'
of sera were determined on 1100 randomly selected healthy adult male and
female blood donors aged 18-50 years. The prospective study was carried out
in Kenyatta National Hospital (KNH), Nairobi, Kenya.
Reference ranges were constructed by using the parametric methods to
estimate 2.5 and 97.5 percentiles of distribution as lower and upper reference
limits, according to the International Federation of Clinical Chemi try (IFCC)
recommendations. To ensure accuracy and reliability during the analytical
period emphasis was laid on the-daily internal quality assurance. The mean ±
(1.96 SD) ofthese biochemical 'analytes for males (m) and females (t) were
as follows: alanine aminotransferase (ALT) [m (0-39) UIL, f (0-34) UIL],
aspartate aminotransferase (AST) [m (6-40) UIL, f (3-37) UIL], alkaline
phosphatase (ALP) [m (l3-201) UIL, f (5-227) UIL], albumin (ALB) [m (29-
52) gIL, f (28-50) gIL], protein (PROT) [m (57-89) gIL, f (56-88) gIL],
creatinine (CREAT) [m (59-127) umol/L, f(54-122) umol/L], glucose (GLU)
[m (2.8-6.8) mmol/L, f (2.6-7) mmol/L] , phosphorus (PHOS) [m (0.5-2.0)
mmol/L, f (0.2-2.4) mmo/L] , potassium (POT) [m (3-5.3), f (3.1-5.1)
mmolL], sodium (SOD) [m (111-153) mmollL, f (117-151) mmol/L], Blood
Vll
urea nitrogen BUN[ m (1.5-5.9) mmol/L, f (1.2-6.0) mmollL] and Uric acid
(UA) [m (120-458) umol/L, f ( 89-415) umol/L]. Sex differences in the
established reference ranges in the current study were found to be significant
in ALT (p=0.000), AST (p=O.OOO),ALP (p<0.003), ALB (p=O.OOO),SOD
(p<0.011), CREAT (p=O.OOO)and UA (p=O.OOO).In age group category one
(18-28 years) of the study population, reference range sex differences were
significant in ALT (p=O.OOO), AST (p=O.OOO), ALB (p<0.002), CREAT
(p=0.000) and VA (p=O.OOO).In age group category two,P9-39 years) of the
study population, reference range sex differences were significant in ALT
(p<O.OI), AST (p<O.OI), ALB (p<0.005), SOD (p<0.04) and VA (p<0.003).
In age group category three (40-50 years) of the study population, reference
range sex differences were significant in AST (p<0.048), ALB (p<0.02), and
UA (p<0.005).
In view of the differences in reference ranges of the study population and that
of the American adult population, it is important that each clinical chemistry
laboratory should have its own reference ranges for the biochemical analytes.
The sex and age of the reference population needs consideration whenever
reference ranges are constructed for other biochemical analytes
Description
A thesis submitted in partial fulfilment for the award of the degree of Master of
Science (Infectious Disease Diagnosis) in the Department of Biochemistry, School
of Pure and Applied Sciences, Kenyatta University, Nairobi, Kenya. RB 112.5 .W3