Comprehensive Metabolic Panel (CMP) Most Popular

The Comprehensive Metabolic Panel (CMP) test contains 1 test with 21 biomarkers.

Brief Description: The Comprehensive Metabolic Panel (CMP) test is a widely used blood test that provides valuable insights into a patient's overall health and helps evaluate the function of various organs and systems in the body. It measures a comprehensive set of chemical substances in the blood, including electrolytes, kidney and liver function markers, glucose, and protein levels. The CMP test offers a comprehensive overview of the body's metabolic state and aids in diagnosing and monitoring various conditions.

Also Known As: CMP, Chem, Chem-21, Chem-12+, Chem-14+, Chem 21 (including chems 12 and 14) Panel, Chemistry Panel, Chem Panel, Chem Screen, Chemistry Screen, SMA 12, SMA 20, SMA 21, SMAC, Chem test

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred.

When is a Comprehensive Metabolic Panel test ordered:  

A Comprehensive Metabolic Panel (CMP) test may be ordered in several situations to assess a patient's health:

1. Routine Health Check-ups: Doctors often include a CMP test as part of routine check-ups to assess overall health, screen for underlying conditions, and establish a baseline for future comparisons.

2. Evaluation of Organ Function: The CMP test provides valuable information about the function of vital organs such as the liver, kidneys, and pancreas. It helps detect abnormalities or diseases affecting these organs, such as liver disease, kidney dysfunction, or diabetes.

3. Monitoring Medications or Treatments: Patients undergoing certain medications or treatments, such as those that may impact liver or kidney function, require regular monitoring through CMP tests to ensure the treatments are well-tolerated and effective.

4. Investigation of Symptoms: When patients present with symptoms like fatigue, abdominal pain, jaundice, frequent urination, or unexplained weight loss, a CMP test can aid in identifying potential underlying causes or imbalances.

What does a Comprehensive Metabolic Panel blood test check for? 

The complete metabolic panel (CMP) is a set of 20 tests that provides critical information to a healthcare professional about a person's current metabolic status, check for liver or kidney disease, electrolyte and acid/base balance, and blood glucose and blood protein levels. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the CMP: 

• Albumin: this is a measure of Albumin levels in your blood. Albumin is a protein made by the liver that is responsible for many vital roles including transporting nutrients throughout the body and preventing fluid from leaking out of blood vessels. 

• Albumin/Globulin Ratio: this is a ratio between your total Albumin and Globulin  

• Alkaline Phosphatase: this is a measure of Alkaline phosphatase or ALP in your blood. Alkaline phosphatase is a protein found in all body tissues, however the ALP found in blood comes from the liver and bones. Elevated levels are often associated with liver damage, gallbladder disease, or bone disorder. 

• Alt: this is a measure of Alanine transaminase or ALT in your blood. Alanine Aminotransferase is an enzyme found in the highest amounts in the liver with small amounts in the heart and muscles. Elevated levels are often associated with liver damage. 

• AST: this is a measure of Aspartate Aminotransferase or AST. Aspartate Aminotransferase is an enzyme found mostly in the heart and liver, with smaller amounts in the kidney and muscles. Elevated levels are often associated with liver damage. 

• Bilirubin, Total: this is a measure of bilirubin in your blood. Bilirubin is an orange-yellowish waste product produced from the breakdown of heme which is a component of hemoglobin found in red blood cells. The liver is responsible for removal of bilirubin from the body. 

• Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

• Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. 

• Calcium: is used for blood clot formation and the formation and maintenance of bones and teeth. 

• Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

• Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

• Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

• Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Globulin: this is a measure of all blood proteins in your blood that are not albumin. 

• Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

• Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

• Protein, Total: this is a measure of total protein levels in your blood. 
  Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

• Sodium: this is a measure of sodium in your blood's serum. Sodium is a vital mineral for nerve and muscle cell function.

• Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood UreaNitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

Depending on the results of a CMP or the suspected conditions, other tests may be ordered for further clarification or investigation:

1. Lipid Panel:

   • Purpose: Measures levels of various types of cholesterol and triglycerides in the blood.
   • Why Is It Ordered: To assess the risk of cardiovascular disease, especially if the CMP suggests diabetes or if the patient has a family history of heart disease.

2. Thyroid Function Tests (TFTs):

   • Purpose: Include measurements of TSH (Thyroid Stimulating Hormone), Free T3, and Free T4.
   • Why Is It Ordered: To investigate symptoms such as fatigue, weight changes, or when lipid levels from the CMP are abnormal, indicating possible thyroid dysfunction.

3. Hemoglobin A1c (HbA1c):

   • Purpose: Provides an average of blood glucose levels over the past three months.
   • Why Is It Ordered: To diagnose or monitor diabetes, especially if the CMP shows high glucose levels.

4. Uric Acid:

   • Purpose: Measures the level of uric acid in the blood.
   • Why Is It Ordered: To help diagnose gout or to further assess kidney function if related abnormalities are found in the CMP.

5. Magnesium:

   • Purpose: An important electrolyte not included in the standard CMP.
   • Why Is It Ordered: To check for magnesium deficiency or excess when symptoms such as muscle cramps or cardiac arrhythmias are present, or if other electrolytes are out of balance.

6. Phosphate:

   • Purpose: Important for bone health and is regulated by the kidneys.
   • Why Is It Ordered: To evaluate further when kidney function is abnormal or if there are concerns related to bone metabolism.

7. Complete Blood Count (CBC):

   • Purpose: Evaluates the levels and health of red blood cells, white blood cells, and platelets.
   • Why Is It Ordered: To provide more information on signs of infection, anemia, or other blood-related issues indicated by the CMP.

8. Coagulation Panel:

   • Purpose: Measures the clotting ability of the blood.
   • Why Is It Ordered: To assess blood clotting function if liver tests are abnormal, due to the liver’s role in producing clotting factors.

9. Serum Iron and Total Iron Binding Capacity, Ferritin, and Transferrin:

   • Purpose: Assess body iron stores and transport.
   • Why Is It Ordered: To identify or rule out disorders of iron metabolism when signs of anemia or liver disease are present on the CMP.

10. C-Reactive Protein (CRP) or Erythrocyte Sedimentation Rate (ESR):

    • Purpose: Non-specific markers of inflammation.
    • Why Is It Ordered: To detect inflammation or infection that might be suggested by abnormalities in the CMP.

11. Hepatitis Panel:

    • Purpose: Screening for viral infections that affect the liver and immune system.
    • Why Is It Ordered: If liver dysfunction is indicated on the CMP, or if the patient has risk factors for these infections, testing is essential for appropriate management.

Conditions where a Comprehensive Metabolic Panel test is recommended: 

A Comprehensive Metabolic Panel (CMP) test can assist in diagnosing and monitoring various conditions or diseases, including:

1. Liver Diseases: The CMP helps identify liver diseases such as hepatitis, cirrhosis, or liver damage due to alcohol abuse or medication toxicity.

2. Kidney Diseases: Abnormalities in kidney function markers on the CMP test can indicate conditions like chronic kidney disease, kidney infections, or kidney stones.

3. Diabetes or Glucose Imbalances: The CMP provides crucial information on blood glucose levels, aiding in the diagnosis and management of diabetes or identifying glucose imbalances.

4. Electrolyte Imbalances: Abnormal levels of electrolytes detected by the CMP can indicate conditions such as dehydration, kidney dysfunction, or hormonal disorders.

How does my healthcare provider use a Comprehensive Metabolic Panel test? 

Health care providers use the results of a Comprehensive Metabolic Panel (CMP) test to:

1. Diagnose Medical Conditions: Abnormalities in CMP test results can help healthcare providers diagnose various conditions such as liver disease, kidney dysfunction, diabetes, or electrolyte imbalances.

2. Monitor Treatment Effectiveness: Regular CMP tests allow healthcare providers to monitor the impact of treatments or medications on organ function, glucose control, or electrolyte balance.

3. Evaluate Overall Health: The CMP test provides a comprehensive snapshot of the patient's metabolic state and aids in evaluating overall health, identifying potential risk factors, and guiding further investigations if necessary.

By effectively utilizing the results of a Comprehensive Metabolic Panel (CMP) test, healthcare providers can diagnose conditions, monitor treatment progress, and make informed decisions regarding patient care and management.

What do my Comprehensive Metabolic Panel test results mean? 

The results of the tests included in the CMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. A high result on one of the liver enzyme tests, for example, is not the same as a high result on several liver enzyme tests. 

Several sets of CMPs, frequently performed on various days, may be examined to gain insights into the underlying disease and response to treatment, especially in hospitalized patients. 

Out-of-range findings for any of the CMP tests can be caused by a variety of illnesses, including kidney failure, breathing issues, and diabetes-related complications, to name a few. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

A wide range of prescription and over-the-counter medications can have an impact on the results of the CMP's components. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide a thorough history because many other circumstances can influence how your results are interpreted. 

What's the difference between the CMP and the BMP tests, and why would my doctor choose one over the other? 

The CMP consists of 14 tests, while the basic metabolic panel (BMP) is a subset of those with eight tests. The liver (ALP, ALT, AST, and bilirubin) and protein (albumin and total protein) tests are not included. If a healthcare provider wants a more thorough picture of a person's organ function or to check for specific illnesses like diabetes or liver or kidney disease, he or she may prescribe a CMP rather than a BMP. 

Please note the following regarding BUN/Creatinine ratio:  The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result. As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79.

25 Most Common Questions about the Comprehensive Metabolic Panel test:

Test Purpose and Frequency

What is the purpose of a Comprehensive Metabolic Panel (CMP) test?

The CMP is a blood test that provides a broad look at your body's chemical balance and metabolism. It gives important information about your body's electrolyte and fluid balance, kidney function, liver function, and blood sugar levels. Doctors use it to screen for and monitor diseases and medical conditions.

How frequently should I get a Comprehensive Metabolic Panel test?

The frequency depends on your health condition and doctor's advice. If you're in good health, your doctor may order it as part of a routine check-up. If you're managing a chronic condition, like diabetes or hypertension, your doctor may order it more frequently to monitor your condition and medication effectiveness.

Components and Normal Ranges

What does a Comprehensive Metabolic Panel test measure?

A CMP measures 16 different substances in your blood. These include various electrolytes (sodium, potassium, calcium, chloride, carbon dioxide/bicarbonate), blood sugar (glucose), kidney tests (BUN and creatinine), liver tests (ALP, ALT, AST, bilirubin), and protein tests (albumin and total protein).

What are the normal ranges for each component of the Comprehensive Metabolic Panel?

Normal ranges can slightly vary depending on a patient's age and gender, but in general the normal ranges are:

• Glucose: 65 to 100 mg/dL
• Calcium: 8.6 to 10.2 mg/dL
• Sodium: 135 to 146 mmol/L
• Potassium: 3.5 to 5.3 mmol/L
• CO2 (carbon dioxide, bicarbonate): 20 to 32 mmol/L
• Chloride: 98 to 110 mmol/L
• BUN (Blood Urea Nitrogen): 7 to 25 mg/dL
• Creatinine: 0.6 to 1.3 mg/dL for men, 0.5 to 1.03 mg/dL for women
• ALP (Alkaline Phosphatase): 36 to 130 U/L for men, 31 to 125 u/L for women
• ALT (Alanine Aminotransferase): 9 to 46 U/L for men, 6 to 29 U/L for women
• AST (Aspartate Aminotransferase): 10 to 40 U/L
• Bilirubin: 0.2 to 1.1 mg/dL
• Total Protein: 6.1 to 8.1 g/dL
• Albumin: 3.6 to 5.1 g/dL

Understanding Test Results

What does a high glucose level mean in a Comprehensive Metabolic Panel test?

A high glucose level can indicate that your body is having trouble processing sugar and may suggest pre-diabetes or diabetes. It can also be elevated temporarily due to stress, illness, certain medications, or after a meal.

What does a low glucose level mean in a Comprehensive Metabolic Panel test?

A low glucose level, also known as hypoglycemia, can occur if you haven't eaten in a while, or if you're taking certain medications for diabetes. It may cause symptoms such as sweating, shakiness, and confusion.

What does a high BUN (Blood Urea Nitrogen) level mean in a Comprehensive Metabolic Panel test?

A high BUN level may indicate that your kidneys aren't functioning properly, or it could also be due to a high protein diet, certain medications, or conditions like heart failure or gastrointestinal bleeding.

What does a low BUN level mean in a Comprehensive Metabolic Panel test?

Low BUN levels are less common and are not typically a cause for concern. They may be seen in severe liver disease, malnutrition, or sometimes during overhydration.

What does a high creatinine level mean in a Comprehensive Metabolic Panel test?

A high creatinine level can indicate kidney dysfunction. Because creatinine is a waste product that the kidneys filter out of the body, its levels can increase when the kidneys aren't working properly.

What does a low creatinine level mean in a Comprehensive Metabolic Panel test?

Low creatinine levels can be seen in conditions that cause decreased muscle mass, such as muscular dystrophy, or in severe liver disease. They are usually not a direct cause for concern.

What does a high ALT or AST level mean in a Comprehensive Metabolic Panel test?

ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are enzymes found in your liver. High levels of these enzymes can indicate liver damage or inflammation, such as from viral hepatitis, alcoholic liver disease, or drug-induced liver injury.

What does a low ALT or AST level mean in a Comprehensive Metabolic Panel test?

Low levels of ALT or AST are typically not a cause for concern and do not indicate a specific medical condition.

What do high or low levels of albumin in a Comprehensive Metabolic Panel test mean?

Albumin is a protein made by your liver that helps keep fluid in your bloodstream so it doesn't leak into other tissues. A low albumin level can indicate liver disease or inflammatory diseases; it can also occur in kidney disease, where albumin is lost in the urine. A high albumin level could be due to dehydration or high protein diet.

CMP in Disease Screening and Monitoring

Can a Comprehensive Metabolic Panel test detect liver disease?

Yes, the CMP includes several tests (ALT, AST, ALP, albumin, and bilirubin) that can indicate if your liver isn’t working properly. However, abnormal results would need to be investigated further to determine the specific type and cause of liver disease.

Can a Comprehensive Metabolic Panel test detect kidney disease?

Yes, the CMP measures blood urea nitrogen (BUN) and creatinine, which can help assess how well your kidneys are functioning. High levels of these substances may suggest kidney disease.

Can a Comprehensive Metabolic Panel test detect diabetes?

Yes, the CMP includes a glucose test, which can detect high blood sugar—a hallmark of diabetes. However, a one-time blood glucose measurement is not enough for a definitive diagnosis of diabetes, and additional testing would be necessary.

Can a Comprehensive Metabolic Panel test detect heart disease?

The CMP does not directly test for heart disease. However, abnormal electrolyte levels (such as potassium and calcium) could affect heart function, and kidney function tests are important because kidney disease is a risk factor for heart disease.

Can a Comprehensive Metabolic Panel test be used to monitor medication effects?

Yes, the CMP can be used to monitor the effects of medications on the kidneys or liver, as well as how they impact your body's electrolyte and fluid balance.

Interpretation of Other CMP Components

What does a high or low sodium level mean in a Comprehensive Metabolic Panel test?

High sodium (hypernatremia) usually indicates dehydration. Low sodium (hyponatremia) can be due to a wide range of conditions including heart, liver, or kidney disease, or it can be caused by drinking too much water.

What does a high or low potassium level mean in a Comprehensive Metabolic Panel test?

High potassium (hyperkalemia) can be caused by kidney disease, certain medications, or conditions that cause excessive release of potassium from cells, like tissue injury or acidosis. Low potassium (hypokalemia) can occur with conditions that cause loss of potassium, like diarrhea or vomiting, or with use of certain medications like diuretics.

What does a high or low chloride level mean in a Comprehensive Metabolic Panel test?

High chloride levels (hyperchloremia) can occur with dehydration, kidney disease, or other conditions that cause an imbalance in the body's acid/base balance. Low chloride levels (hypochloremia) can occur with conditions that cause excessive loss of fluid, like vomiting or chronic lung diseases.

What does a high or low calcium level mean in a Comprehensive Metabolic Panel test?

High calcium levels (hypercalcemia) can occur with certain types of cancer, hyperparathyroidism, or excessive intake of vitamin D or calcium. Low calcium levels (hypocalcemia) can be seen with hypoparathyroidism, vitamin D deficiency, or low protein levels.

What does a high or low carbon dioxide (bicarbonate) level mean in a Comprehensive Metabolic Panel test?

High carbon dioxide levels can be seen in conditions causing your body to have too much base (alkalosis), such as prolonged vomiting, lung diseases, or hormone disorders. Low carbon dioxide levels can indicate too much acid in the blood (acidosis), such as from kidney disease, metabolic disorders, or severe infections.

What does a high or low total protein level mean in a Comprehensive Metabolic Panel test?

High total protein levels can occur with chronic inflammation or infection, multiple myeloma, or dehydration. Low total protein levels can indicate malnutrition, liver disease, kidney disease (where protein is lost in the urine), or conditions where protein is not being absorbed properly from the diet.

Can a Comprehensive Metabolic Panel test give indications about my overall nutritional status?

The CMP can provide some information about nutrition. For example, low albumin levels can suggest poor nutrition, and glucose levels can show if you're getting too much sugar. However, for a full assessment of nutritional status, additional tests (such as vitamin levels) and a dietary review would be needed.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.