Comprehensive Metabolic Panel

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What is a Comprehensive metabolic panel (CMP)?

The comprehensive metabolic panel (CMP) comprises a screening panel of 14 different tests that provides a full picture of patients’ metabolism, the function of organs and detects the presence of specific health conditions such as kidney and liver disease, or diabetes. Health practitioners order this test as part of routine medical examination to get a clear picture of the body’s chemistry and functioning. The CMP panel of tests usually includes the following investigations:

Electrolyte test– Forms part of the CMP screening tests that evaluate the level of vital electrolytes such as sodium and potassium in the blood. Electrolytes like sodium and potassium are key for body functions. Electrolytes regulate the fluid balance in the body. Sodium and potassium help the nerves and muscles to perform their functions. Electrolytes regulate heartbeat and help the brain do its job well. If electrolyte results are abnormal, it can be indicative of kidney or heart disease.  Dehydration also causes abnormal electrolyte levels.

CO2 (carbon dioxide, bicarbonate) – Checks the presence of CO2 in the blood for effective regulation of acid-base balance (pH) in the body.

Chloride – This test evaluates the presence of chloride in the blood, which helps keep fluid and acid-base levels in check.

Blood glucose– This test helps investigate and measure blood glucose in the body in order to evaluate how the source of energy is used.

Proteins– This test measures albumin levels in the blood. The liver produces the protein called albumin. This test also checks for the levels of all other proteins under the Total protein test. Proteins contribute to the formation of healthy organs, blood, muscles, and bones. If the protein level in the blood is low, it means you could be deficient in nutrition or it could be indicative of a kidney or liver disease. 

Kidney Tests – BUN (blood urea nitrogen) – This test measures the blood urea and nitrogen levels. If the kidney is functioning well, then the filtration of waste products is efficient. If the blood urea nitrogen level is abnormal, it is indicative of kidney disease.

Creatinine – Creatinine is produced by the muscles and is thrown out of the body as a waste product by the kidneys.  This test measures the functioning of the kidneys by measuring creatinine levels in the blood.
Calcium Test – This test ascertains levels of the crucial mineral, calcium to evaluate its content in the body.  Calcium is which is required for bone health the heart, nerves, and muscles to function well. Calcium is crucial for the health of the nerves, hormones and muscles. Abnormal calcium level in the blood points to an imbalance in hormonal levels or problems with kidneys, pancreas or bones. 

Liver Test – The liver tests seek to check levels of three substances produced by the liver- ALP, ALT, and AST.  Bilirubin, produced by the liver, is also measured during the blood test. ALP or alkaline phosphatase is an enzyme found in the liver, tissues, and bones. Increased level of ALP is a sign of bone disorder and liver disease. 

Is this test referred by alternative names?

The comprehensive metabolic panel test is also known as the metabolic panel, CMP, chem 14, chemistry panel, chemistry screen. It used to be earlier known by SMAC, sequential multiple analyzers, and chemistry tests.

Why has the doctor ordered this test for me?

Your doctor may want to assess your metabolism as well as ascertain the functioning of your kidneys and liver. Some of the reasons for the comprehensive metabolic panel test are to check:

– Metabolism
– Liver functioning health
– Kidney health
– Acid-base balance
– Electrolyte balance
– Blood proteins
– Blood glucose
Hypertension

The extent of the side effects of medications on the liver and kidney

What is the ideal time to be tested?

Doctors usually recommend the comprehensive metabolic test as part of the routine health evaluation. The test is also performed to keep track of a specific medical condition or investigate the impact of medicines on the kidney and liver.

How is the test performed?

The comprehensive metabolic panel test requires a blood sample. It is a simple procedure and can be performed in a laboratory. A technician draws a blood sample from a vein in the arm. There are usually no side effects, and only in extreme cases, can bruising or excessive bleeding occur. Some patients report feeling light-headed, but they recover soon. The test is done in a few minutes.

How should I adequately prepare for this test?

Keep your health care provider informed about your medical conditions and all the medicines, vitamins and supplements you are on. If you are on any illicit drugs or on prescription medicines, it is important to convey this information to your doctor. It is important to follow all the instructions given to you.

Do I need to fast before the CMP test?

Before the blood sample is drawn, you may need to fast for about 10 to 12 hours. You can, of course, consume water during the fast. If a postprandial blood sample is needed, you will be required to consume food.  A blood sample is drawn after a couple of hours to evaluate blood glucose levels.

What factors might alter my test results?

Factors that can alter your comprehensive metabolic panel test are:

– Alcohol consumption prior to the test
– Medications such as insulin or steroids. Hormonal medicines may also influence test results
– Consuming food before the test
– Engaging in physical activity or exercise before the test
– Damage of blood cells during the collection of sample or processing test

What is the reference range for the test results of CMP?

Liver function test

Test    Normal Range
ALP (alkaline phosphatase) 44 to 147 IU/L
Alanine amino transferase(ALT) 7 to 40 IU/L
Bilirubin 0.3 to 1.9 mg/dL
AST (aspartate amino transferase) 10 to 34 IU/L

Kidney tests
TestNormal range
BUN6-20 mg/dL
Creatinine 0.6 to 1.3 mg/dL

Electrolytes
Test Normal Range
Sodium 136 to 145 meq/L
Potassium 3.5 to 5.1 meq/L
Chloride 96 to 106 meq/L
CO2 23 to 29 meq/L

Proteins
Test Normal Range
Albumin 3.4 to 5.4 g/dL
Total protein 6.0 to 8.3 g/dL

Glucose
Test Normal Range
Blood sugar  70 to 99 mg/dL

Calcium
Test Normal Range
Calcium 8.6 to 10.2 mg/dL.

How do I interpret the test results?

The test results are best interpreted with the help of your healthcare provider. Doctors compare results with the reference range and if they fall within the range, the results are normal.  The results of other medical examinations in the context are also analyzed. In case the results do not fall within the reference range, then the results are considered abnormal. Your doctor will recommend the next course of action if the results are abnormal.

Doctors usually analyze the test results keeping other medical examinations and records in the context. Further, if a test value is only slightly higher or lower as compared to the reference range,  your health provider may ask for a repeat test.

Is the CMP test performed on children?

Doctors may order CMP tests for kids to evaluate the functioning of their bodies, their metabolism and the health of the liver and kidneys.

Is this test performed during pregnancy?

The comprehensive panel test is very important during pregnancy as it evaluates the health of the mother by checking the function of important organs as well as measures the presence of important minerals such as calcium. This test also measures blood health and electrolyte levels. If the mothers’ health is not up to the mark, this can adversely affect the health of the fetus.

What is the cost of a comprehensive metabolic panel test in India?

The cost of the comprehensive metabolic panel test in India depends on the location and the facility offering the services. Usually, the price of this test ranges from INR 2650 – 3000.

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