The comprehensive metabolic panel (CMP) is used as a broad screening tool to evaluate organ function and check for conditions such as diabetes, liver disease, and kidney disease. The CMP may also be ordered to monitor known conditions, such as hypertension, and to monitor people taking specific medications for any kidney- or liver-related side effects.
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Computer screen report of a comprehensive metabolic panel. | |
MedlinePlus | 003468 |
LOINC | 24322-0, 24323-8 |
The comprehensive metabolic panel, or chemical screen, (CMP; CPT code 80053) is a panel of 14 blood tests which serves as an initial broad medical screening tool. The CMP provides a rough check of kidney function, liver function, diabetic and parathyroid status, and electrolyte and fluid balance, but this type of screening has its limitations. Abnormal values from a CMP are often the result of false positives and thus the CMP may need to be repeated (or a more specific test performed), requiring a second blood drawing procedure and possibly additional expense for the patient, even though no disease is present. This test is also known as SMA12+2 test.
The CMP is an expanded version of the basic metabolic panel (BMP), which does not include liver tests. A CMP (or BMP) can be ordered as part of a routine physical examination, or may be used to monitor a patient with a chronic disease, such as diabetes mellitus or hypertension.
Previous names for the panel of tests have been Chem 12, Chemistry panel, Chemistry screen, SMA 12, SMA 20 and SMAC (Sequential Multiple Analysis - Computer).[1] The tests are performed on machines based on the AutoAnalyzer invented in 1957.
- 1Testing
Testing[edit]
BMP/ELECTROLYTES: | |||
Na+ = 140 | Cl− = 100 | BUN = 20 | / |
Glu = 150 | |||
K+ = 4 | CO2 = 22 | PCr = 1.0 | |
ARTERIAL BLOOD GAS: | |||
HCO3− = 24 | paCO2 = 40 | paO2 = 95 | pH = 7.40 |
ALVEOLAR GAS: | |||
pACO2 = 36 | pAO2 = 105 | A-a g = 10 | |
OTHER: | |||
Ca = 9.5 | Mg2+ = 2.0 | PO4 = 1 | |
CK = 55 | BE = −0.36 | AG = 16 | |
SERUM OSMOLARITY/RENAL: | |||
PMO = 300 | PCO = 295 | POG = 5 | BUN:Cr = 20 |
URINALYSIS: | |||
UNa+ = 80 | UCl− = 100 | UAG = 5 | FENa = 0.95 |
UK+ = 25 | USG = 1.01 | UCr = 60 | UO = 800 |
PROTEIN/GI/LIVER FUNCTION TESTS: | |||
LDH = 100 | TP = 7.6 | AST = 25 | TBIL = 0.7 |
ALP = 71 | Alb = 4.0 | ALT = 40 | BC = 0.5 |
AST/ALT = 0.6 | BU = 0.2 | ||
AF alb = 3.0 | SAAG = 1.0 | SOG = 60 | |
CSF: | |||
CSF alb = 30 | CSF glu = 60 | CSF/S alb = 7.5 | CSF/S glu = 0.4 |
Typically, the patient fasts for ten or twelve hours before the blood is drawn for the test—this is particularly important for getting a useful blood glucose measurement. CMPs are also frequently performed on nonfasting patients, but the glucose level in those cases is not as useful. The following tests are then performed:[1]
General tests[edit]
These tests help screen for a wide variety of problems. The glucose test in particular helps screen for diabetes mellitus and pre-diabetes. The calcium test can indicate or monitor bone diseases or diseases of the parathyroid gland or kidneys. Calcium salts, lithium, thiazide diuretics, thyroxine, and vitamin D can all increase levels and may interfere with this test.[2]
Kidney function assessment[edit]
- Blood urea nitrogen (BUN)
Electrolytes[edit]
Electrolyte levels and the balance among them are tightly regulated by the body. Both individual values and ratios among the values are significant; abnormalities among either can indicate problems such as an electrolyte disturbance, acid-base imbalance, or kidney dysfunction.
- Carbon dioxide (CO2)
Protein tests[edit]
Tests of protein levels in the blood help screen for both kidney and liver disorders.
- Serum total protein (TP)
Liver function assessment[edit]
- Alkaline phosphatase (ALP)
- Aspartate amino transferase (AST or SGOT)
- Alanine amino transferase (ALT or SGPT)
Results[edit]
The U.S. NIH provides ranges considered within normal limits, though optimal levels may vary by individual.[3]
Compare also the ranges given at Reference ranges for blood tests.
Specimen | Normal Range[3] | Units |
---|---|---|
Albumin | 3.9 - 5.0 | g/dL |
Alkaline phosphatase | 44 - 147 | IU/L |
ALT (alanine aminotransferase) | 8 - 37 | IU/L |
AST (aspartate aminotransferase) | 10 - 34 | IU/L |
BUN (blood urea nitrogen) | 7 - 20 | mg/dL |
Calcium | 8.5 - 10.9 | mg/dL |
Chloride | 96 - 106 | mmol/L |
CO2 (carbon dioxide) | 20 - 29 | mmol/L |
Creatinine | 0.6 - 1.1 (women)[4] 0.7 - 1.3 (men) | mg/dL |
Glucose | 70 - 100 | mg/dL |
Potassium | 3.7 - 5.2 | mEq/L |
Sodium | 136 - 144 | mEq/L |
Total bilirubin | 0.2 - 1.9 | mg/dL |
Total protein | 6.3 - 7.9 | g/dL |
See also[edit]
References[edit]
- ^ ab'Comprehensive Metabolic Panel'. Lab Tests Online. 2005-10-31. Retrieved 2008-09-22.
- ^'Calcium - blood test'. MedlinePlus Medical Encyclopedia. Nlm.nih.gov. 2012-08-27. Retrieved 2012-09-14.
- ^ ab'Comprehensive metabolic panel: MedlinePlus Medical Encyclopedia'. NLM.NIH.gov. 2013-01-21. Retrieved 2015-04-29.
- ^'Creatinine blood test: MedlinePlus Medical Encyclopedia'. NLM.NIH.gov. 2013-08-04. Retrieved 2015-04-29.
External links[edit]
- Comprehensive Metabolic PanelAmerican Association for Clinical Chemistry 2012
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A comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metabolism refers to all the physical and chemical processes in the body that use energy.
You should not eat or drink for 8 hours before the test.
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away.
This test gives your health care provider information about:
- How your kidneys and liver are working
- Blood sugar and calcium levels
- Sodium, potassium, and chloride levels (called electrolytes)
- Protein levels
Your provider may order this test to check you for side effects of medicines or diabetes, or for liver or kidney disease.
Normal values for the panel tests are:
- Albumin: 3.4 to 5.4 g/dL (34 to 54 g/L)
- Alkaline phosphatase: 20 to 130 U/L
- ALT (alanine aminotransferase): 4 to 36 U/L
- AST (aspartate aminotransferase): 8 to 33 U/L
- BUN (blood urea nitrogen): 6 to 20 mg/dL (2.14 to 7.14 mmol/L)
- Calcium: 8.5 to 10.2 mg/dL (2.13 to 2.55 mmol/L)
- Chloride: 96 to 106 mEq/L (96 to 106 mmol/L)
- CO2 (carbon dioxide): 23 to 29 mEq/L (23 to 29 mmol/L)
- Creatinine: 0.6 to 1.3 mg/dL (53 to 114.9 µmol/L)
- Glucose: 70 to 100 mg/dL (3.9 to 5.6 mmol/L)
- Potassium: 3.7 to 5.2 mEq/L (3.70 to 5.20 mmol/L)
- Sodium: 135 to 145 mEq/L (135 to 145 mmol/L)
- Total bilirubin: 0.1 to 1.2 mg/dL (2 to 21 µmol/L)
- Total protein: 6.0 to 8.3 g/dL (60 to 83 g/L)
Normal values for creatinine can vary with age.
Normal value ranges for all tests may vary slightly among different laboratories. Some labs use different measurements or may test different specimens. Talk to your provider about the meaning of your specific test results.
Abnormal results can be due to a variety of different medical conditions. These may include kidney failure, liver disease, breathing problems, and diabetes or diabetes complications.
There is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Multiple punctures to locate veins
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Chernecky CC, Berger BJ. Comprehensive metabolic panel (CMP) - blood. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:372.
McPherson RA, Pincus MR. Disease/organ panels. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:appendix 7.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.