Establishment of Reference Ranges for Biochemical Parameters in Children and Adolescents of Ages 1-17 Years in Meru County, Kenya
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Date
2019
Authors
Kainyu, Munene Rhoda
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
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.
Description
A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science (Medical Biochemistry) of Kenyatta University
Keywords
Reference Ranges, Biochemical, Adolescents, Meru County, Kenya