CMP

Comprehensive Metabolic Panel (CMP)

Overview

A metabolic panel is a group of tests that measures different chemicals in the blood. These tests are usually done on the fluid (plasma) part of blood. The tests provide information about your body’s chemical balance and metabolism. They can give doctors information about your muscles (including the heart), bones, and organs, such as the kidneys and liver.

There are two types: basic metabolic panel (BMP) and comprehensive metabolic panel (CMP). The BMP checks your blood sugar, calcium, and electrolytes. The BMP also has tests such as creatinine to check your kidney function. The CMP includes all of those tests, as well as tests of your cholesterol, protein levels, and liver function.

What Tests are Included in CMP?

Diabetes

Glucose is the body’s main source of energy and is produced during the breaking down of carbohydrates. Glucose levels should rise after a meal and then decrease over time. If glucose levels remain constantly high it can cause damage to the body. Testing the level of glucose in the blood is one of the best ways to determine the presence of diabetes, pre-diabetes and is one of the tests included in a CMP blood test.

Kidney Function

Creatinine is a waste product found in the blood and urine. Creatinine is produced during the process of the body’s mobilization of food. Creatinine is filtered out of the blood by the kidneys and transferred to the urine. Lower levels of creatinine in the urine and higher levels in the blood points to a problem in kidney function. Creatinine levels helps a physician identify important diseases including glomerulonephritis (inflammation of the glomeruli due to damage), pyelonephritis (bacterial infection of the kidneys), prostate disease (such as an enlarged prostate), blockage of the urinary tract (maybe due to kidney stones), decreased blood flow to the kidneys, which may be caused by congestive heart failure, diabetes, or dehydration, the death of kidney cells as a result of drug abuse, streptococcal infections (such as poststreptococcal glomerulonephritis).

Like creatinine, urea is a waste product that can be tested to gauge kidney functioning. Urea is produced during the breaking down of proteins in the body. High blood levels of urea point to potential kidney problems.

Liver Function

Albumin is a protein that is produced by the liver. One of the main functions of albumin is to keep blood inside of the blood vessels. Albumin is also used in the transportation of acids, hormones, and drugs through the blood system. Low levels of albumin in the blood may be due to poor liver functioning or other health concerns, such as malnutrition. Globulin refers to a group of proteins in the blood that help with blood circulation. Lower than normal range globulin levels may be a sign of renal concerns, while higher than normal range globulin levels may be a sign of a bone marrow disorder.

The total protein blood test is a combined measure of the two proteins albumin and globulin. This test helps to evaluate liver and kidney functioning.  It’s used as part of your routine health checkup. It may also be used if you have edema, unexpected weight loss, fatigue, or the symptoms of a kidney or liver disease.

Bilirubin is an orange-yellow pigment that occurs normally when part of your red blood cells break down. A bilirubin test measures the amount of bilirubin in your blood. It’s used to help find the cause of health conditions like jaundice, anemia, and liver disease. In children and adults, doctors use it to diagnose and monitor liver and bile duct diseases. These include cirrhosis, hepatitis, and gallstones. It’ll also help determine if you have sickle cell disease or other conditions that cause hemolytic anemia. That’s a disorder where red blood cells are destroyed faster than they’re made.

ALT (used to be called serum glutamic-pyruvic transaminase, or SGPT) is produced mainly in the liver, but also in the kidneys, heart, and pancreas. A high level of ALT in the blood is normally caused by damage to the liver including jaundice or hepatitis, cirrhosis, death of liver tissue, a tumor or cancer in the liver, a lack of blood flow to the liver, hemochromatosis (a disorder that causes iron to build up in the body), mononucleosis (an infection usually caused by the Epstein-Barr virus), and pancreatitis (an inflammation of the pancreas).

Alkaline phosphatase is an enzyme that is produced in the organs and in the bones. It is most prolifically produced in the liver, and low levels of ALP can indicate poor liver functioning; such as hepatitis, liver cancer and cirrhosis, but can also be due to a bone-related disorder; such as Paget disease, bone cancer, and issues as a result of vitamin D deficiency.

AST is an enzyme found in the red blood cells, liver, heart, pancreas, kidneys, and in muscle tissue. When there is damage to one of these areas, more AST is produced and released into the blood. AST is also called SGOT (serum glutamic-oxaloacetic transaminase). Normally, AST levels in your blood are low. When your liver is damaged, it puts more AST into your blood, and your levels rise. A high AST level is a sign of liver damage, but it can also mean you have damage to another organ that makes it, like your heart or kidneys.

Fluids and Electrolytes

Sodium is a mineral that helps to keep a proper balance of water and electrolytes in the body. Sodium is important in nerve, muscle, liver, and kidney functioning. Most of the sodium in the body (about 85%) is found in blood and lymph fluid. Sodium levels in the body are partly controlled by a hormone called aldosterone, which is made by the adrenal glands . Aldosterone levels tell the kidneys when to hold sodium in the body instead of passing it in the urine. Small amounts of sodium are also lost through the skin when you sweat.

Too much sodium — which the body mainly gets from salt — leads to the body retaining fluid. This can lead to high blood pressure (hypertension) and other issues. Low sodium levels are uncommon and are most often caused by heart failure, malnutrition, and diarrhea.

Potassium serves much the same function in the body as sodium does. Levels of sodium and potassium often compensate for one another. When potassium levels are low, sodium levels are high and vice versa. Kidney disease is a common cause of a high potassium level. Either high or low potassium levels can cause heart problems. Low potassium can cause muscle cramps.

CO2 is a waste product of the metabolizing process. More than 90% of it in your blood exists in the form of bicarbonate (HCO3), the rest of it is either dissolved carbon dioxide gas (CO2) or carbonic acid (H2CO3). The CO2 is then transferred to the lungs where it is exhaled from the body. The liver and kidneys help to balance the level of CO2 in the blood

Calcium is the most abundant mineral in the body and is used in many of its functions. Calcium is kept in bones and is used in the building of teeth and bones, and in the functioning of the muscles, nerves, and brain. Calcium test let us identify bone diseases such as osteoporosis, cancer of the breast, lung, kidney, head, and neck, or multiple myeloma, kidney or liver disease, overactive thyroid gland, nerve problem, pancreatitis, parathyroid disease and colon cancer.

Chloride is the most important electrolyte in the blood that is important in the regulation of blood pressure, blood volume, and blood pH levels.

Normal Values

Normal values for the panel tests are:

Normal values for creatinine can vary with age.

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