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What Is a Comprehensive Metabolic Panel?

A comprehensive metabolic panel (CMP) is a series of 14 blood tests. It gives your doctor a snapshot of how your liver and kidneys are working, your blood sugar (glucose) level, and your electrolyte and fluid balance.

 

A CMP is a standard blood test that measures your blood sugar levels, how your kidneys and liver function, and your electrolyte and fluid levels. (Photo Credits: iStock/Getty Images)

The 14 tests include alkaline phosphatase(ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, blood urea nitrogen (BUN), creatinine, sodium, potassium, carbon dioxide, chloride, albumin, total protein, glucose, and calcium.

It’s also called a metabolic panel, chem 14, chemistry panel, or chemistry screen.

Comprehensive metabolic panel vs. basic metabolic panel

The doctor may test you with a basic metabolic panel (BMP) instead of a CMP based on your health history and your needs. A BMP can help your doctor understand how your body is using your food and how the chemicals in your body are balanced. It includes eight of the same tests as a CMP: BUN, creatinine, carbon dioxide, chloride, potassium, sodium, glucose, and calcium. Your doctor may order this instead of a CMP:

• As part of your regular checkup
• When you go to the ER
• When you have some long-term conditions, such as high blood pressure or kidney disease

It's also called a chem 7 or electrolyte panel.

Why Are Comprehensive Metabolic Panels Done?

You may get a CMP as part of your yearly checkup, or you may get it to check for kidney or liver diseases. The doctor might also want one to check you for any medical problems, keep track of any chronic conditions you have, or make sure certain medications aren’t hurting your liver or kidneys.

The CMP can tell your doctor:

• How your kidneys and liver are working
• How much protein is in your blood 
• Your electrolyte levels
• The balance of acid and base in your blood
• Your blood sugar levels

Comprehensive Metabolic Panel Tests

Most labs do the same tests, but this may vary slightly depending on the lab or what your doctor has asked them to test.

Most CMPs include the following 14 tests:

CMP liver and protein tests

Albumin. It's made in your liver and is the main protein in your blood and carries hormones, vitamins, and enzymes throughout your body. Low levels may be a sign of liver or kidney disease or another medical condition. High levels may be a sign of dehydration.

Alkaline phosphatase (ALP). It's a protein made in your liver, bones, kidneys, and digestive system. Abnormal levels of ALP may be a sign of health conditions, such as liver disease, bone disorders, and chronic kidney disease.

Alanine aminotransferase (ALT). It's a protein made mostly in the liver. Damaged liver cells release ALT into your blood. High levels in your blood may be a sign of liver injury or disease. You may have high ALT levels in your blood before you have any symptoms, so an ALT test can give your doctor a way of catching some liver diseases early.

Aspartate aminotransferase (AST). This protein is made mostly in your liver, but also in some muscles and other organs. Your doctor may use this test to help diagnose or monitor liver damage or disease.

Total protein. It refers to the total amount of protein in your blood, which includes albumin and globulin. Globulins are proteins that help fight infections and carry nutrients in your body. Some globulins are made in the liver and others are made by the immune system. Low total protein levels can be a sign of a serious health problem.

Bilirubin. It's a yellow chemical your body makes when it breaks down old red blood cells. Your liver usually filters most of the bilirubin out of your blood. If your liver is damaged, bilirubin can leak out. If you have too much bilirubin in your blood, you may get jaundice, when your skin and eyes turn yellow. This test can help your doctor check on how well your liver is working.

CMP kidney tests

Blood urea nitrogen (BUN). Urea nitrogen is a waste product that your kidneys filter out of your blood. High BUN levels may be a sign that your kidneys aren't working well. You may have high BUN levels in your blood before you have any symptoms of kidney disease, so this test can give your doctor a way of catching some kidney problems early. This test may also be called a urea nitrogen test or serum BUN.

Creatinine. It's a normal breakdown product in your body. Your muscles make it when you work them hard. Your kidneys usually filter creatinine out of your blood. High levels of creatinine may be a sign of kidney disease, dehydration, muscle disorders, body injury, muscular dystrophy, or intense exercise. This test may also be called serum creatinine, kidney function, or renal function. The lab often uses this result to calculate an estimated glomerular filtration rate (eGFR) and also compares it to your BUN. These calculations can help your doctor figure out if you have a serious kidney problem and possibly why you're having it.

CMP electrolyte tests

Carbon dioxide (CO2) is a breakdown product your body makes when you digest food. You breathe it out of your lungs when you exhale. Most of the CO2 in your blood is bicarbonate, which is an electrolyte. Electrolytes are electrically charged minerals that help you control the amount of fluid in your body as well as your pH balance (balance of acids and bases). High or low levels can be a sign you have an electrolyte imbalance. Diseases that can cause an electrolyte imbalance include high blood pressure and kidney, lung, or liver conditions.

Chloride is a type of electrolyte, and abnormal levels can be a sign you have an electrolyte imbalance. High levels may be a sign of dehydration, kidney disease, or acidosis (having too much acid in your blood). Low levels may be a sign of heart failure, lung disease, Addison disease (a condition where your adrenal glands don't make enough of certain hormones), or alkalosis (having too much base in your blood). You may also have abnormal levels of chloride if you are overhydrated, dehydrated, or if you've taken antacids.

Potassium isnecessary for your cells, nerves, heart, and muscles to work well. High levels may be a sign of kidney disease, Addison disease, or type 1 diabetes. High levels may also be from injury, burns, surgery, or certain medicines, such as diuretics or antibiotics. Low levels may be a sign of adrenal gland disorders (such as Cushing's syndrome and aldosteronism), kidney disease, or alcohol use disorder. It can also be from diuretics, dehydration, or laxatives.

Sodium is necessary for your nerves and muscles to work well. High levels may be a sign of dehydration, adrenal gland disorders, kidney problems, and diabetes insipidus (a disorder of your kidneys or pituitary gland that makes you very thirsty so that you drink and pee a lot). Low levels may be a sign of dehydration, kidney diseases, cirrhosis of the liver, heart failure, Addison disease, some brain and lung diseases, and some types of cancer. It can also be from over-the-counter pain medicine or antidepressants.

CMP glucose test

Glucose is a type of sugar and your body's main source of energy. High levels may be a sign of diabetes or other disorders of your pancreas, hyperthyroidism, or stress from surgery, trauma, or other serious illnesses. If you have diabetes, low levels may be due to too much diabetes medicine, not eating enough, or exercising more than you usually do. If you don't have diabetes, low levels may be a sign of liver or kidney disease, alcohol use disorder, hypothyroidism, or an underactive adrenal or pituitary gland.

CMP calcium test

Calcium is one of the most important minerals in your body. You need the right amount of calcium in your blood for your nerves, muscles, and heart to work well. Low levels of calcium may be a sign of bone disease, thyroid disease, parathyroid disorders, kidney disease, or other conditions.

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Comprehensive Metabolic Panel Results

Reference ranges depend on the lab that analyzes your blood tests because different labs use their own equipment. They also have different ways of analyzing your blood.

Your doctor will look at all your test results together to see if there are patterns that suggest a medical condition. They will also consider your health history, any medicines you take, and any other factors that may affect your results. Ask your doctor to help you understand what your results mean.

Normal comprehensive metabolic panel results

General ranges for normal results are as follows:

• Albumin: 3.4-5.4 grams/deciliter (34 to 54 grams/liter)
• ALP: 20-130 units/liter
• ALT: 4-36 units/liter
• AST: 8-33 units/liter
• Total protein: 6.0-8.3 grams/deciliter (60 to 83 grams/liter)
• Bilirubin: 0.1-1.2 milligrams/deciliter (2 to 21 micromoles/liter)
• BUN: 6-20 milligrams/deciliter (2.14 to 7.14 millimoles/liter)
• Creatinine: 0.6-1.3 milligrams/deciliter (53 to 114.9 micromoles/liter)
• CO2 (carbon dioxide): 23-29 milliequivalents/liter (23 to 29 millimoles/liter)
• Chloride: 96-106 milliequivalents/liter (96 to 106 millimoles/liter)
• Potassium: 3.7-5.2 milliequivalents/liter (3.70 to 5.20 millimoles/liter)
• Sodium: 135-145 milliequivalents/liter (135 to 145 millimoles/liter)
• Glucose: 70-100 milligrams/deciliters (3.9 to 5.6 millimoles/liter)
• Calcium: 8.5-10.2 milligrams/deciliter (2.13 to 2.55 millimoles/liter) 

 

But always go by the ranges that are on your report because that’s what your doctor will use.

Ask your doctor about any abnormal results because they can help you understand what your results mean.

 

https://www.webmd.com/a-to-z-guides/comprehensive-metabolic-panel

If Your Blood Could Talk—What Is a Comprehensive Metabolic Panel?