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Panel Overview

The Comprehensive Metabolic Panel (CMP) is a 14-test panel that provides a broad assessment of metabolic function, including glucose metabolism, kidney function, electrolyte balance, and liver enzymes. The CMP is one of the most commonly ordered laboratory panels in medicine and serves as a foundational screening tool for metabolic status.

This panel combines elements of the Basic Metabolic Panel (BMP) with liver function tests and additional markers, making it an efficient way to evaluate multiple organ systems simultaneously. The CMP is particularly valuable for initial workup, monitoring chronic conditions, medication effects, and perioperative assessment.

Clinical Applications

  • Routine Screening: Comprehensive health assessment and annual physical exams
  • Diabetes Management: Monitoring glucose control and screening for diabetic nephropathy
  • Kidney Disease: Assessment of renal function and electrolyte balance in AKI and CKD
  • Liver Disease: Screening for hepatic dysfunction and monitoring liver enzyme trends
  • Medication Monitoring: Evaluating metabolic effects of medications and guiding dose adjustments
  • Perioperative Assessment: Preoperative screening and postoperative monitoring

Glucose & Mineral Metabolism

Glucose

Fasting: 70-100 mg/dL

Primary energy source and key marker for diabetes screening and management. Elevated in diabetes mellitus, critical illness, and steroid use.

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Calcium

Normal: 8.5-10.5 mg/dL

Essential mineral for bone health, neuromuscular function, and cardiac conduction. Abnormalities can cause serious cardiac arrhythmias.

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Kidney Function Tests

BUN

Normal: 6-24 mg/dL

Blood Urea Nitrogen - waste product from protein metabolism. Elevated in renal failure, dehydration, and high protein states.

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Creatinine

Normal: 0.6-1.2 mg/dL

Waste product from muscle metabolism. More specific than BUN for kidney function. Used to calculate eGFR.

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eGFR

Normal: ≥90 mL/min/1.73m²

Estimated Glomerular Filtration Rate using creatinine, age, sex, and race. Best overall indicator of kidney function.

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BUN:Cr Ratio

Normal: 10:1 to 20:1

Ratio helps differentiate prerenal azotemia from intrinsic renal failure. Elevated ratio suggests dehydration or prerenal causes.

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Electrolytes

Sodium (Na+)

Normal: 136-145 mEq/L

Primary extracellular cation regulating fluid balance and osmolality. Abnormalities cause hypo/hypernatremia.

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Potassium (K+)

Normal: 3.5-5.0 mEq/L

Critical for cardiac and neuromuscular function. Abnormalities can cause life-threatening arrhythmias.

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Chloride (Cl-)

Normal: 96-106 mEq/L

Major extracellular anion that helps maintain acid-base balance and osmolality. Often changes with sodium.

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Bicarbonate (CO2)

Normal: 22-28 mEq/L

Key buffer in acid-base balance. Decreased in metabolic acidosis. Measured as total CO2 on metabolic panels.

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Liver Enzymes & Proteins

Albumin

Normal: 3.5-5.5 g/dL

Major serum protein maintaining oncotic pressure. Decreased in liver disease, malnutrition, and protein-losing states.

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Total Protein

Normal: 6.0-8.3 g/dL

Sum of albumin and globulins. Reflects nutritional status, liver function, and immune status.

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ALP

Normal: 30-120 U/L

Alkaline Phosphatase from liver and bone. Elevated in cholestatic liver disease, bone disorders, and pregnancy.

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AST

Normal: 10-40 U/L

Aspartate Aminotransferase found in liver, heart, muscle. Elevated in hepatocellular injury, MI, rhabdomyolysis.

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ALT

Normal: 7-56 U/L

Alanine Aminotransferase - more liver-specific than AST. Elevated in hepatocellular injury and hepatitis.

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Bilirubin (Total)

Normal: 0.1-1.2 mg/dL

Breakdown product of hemoglobin. Elevated in liver disease, hemolysis, and biliary obstruction causing jaundice.

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Ammonia

Normal: 15-45 μg/dL

Nitrogen metabolism marker processed by liver. Elevated in hepatic encephalopathy, liver failure, and urea cycle disorders.

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