Waithaka, Stanley King'e2016-08-122016-08-122003-10http://ir-library.ku.ac.ke/handle/123456789/14880A 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 .W3Reference 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 analytesenThesis