View source for Comprehensive metabolic panel

{{short description|Blood test assessing vital organ health}}
{{Medref|date=November 2021}}
{{Infobox diagnostic
| Name            = Comprehensive metabolic panel
| Image           = CMP report.JPG
| Alt             =
| Caption         = Computer screen report of a comprehensive  [[metabolism|metabolic]] panel.
| DiseasesDB      =
| ICD10           =
| ICD9            =
| ICDO            =
| MedlinePlus     = 003468
| eMedicine       =
| MeshID          =
| LOINC           = {{LOINC|24322-0}}, {{LOINC|24323-8}}
| HCPCSlevel2     =
| Reference_range =
}}
The '''comprehensive metabolic panel''', or '''chemical screen''' ('''CMP'''; [[Current Procedural Terminology|CPT]] code 80053), is a [[test panel|panel]] of 14 [[blood test]]s that serves as an initial broad medical [[Screening (medicine)|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 [[Type I and type II errors#Medical testing|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).<ref name="labtests" />  The tests are performed on machines based on the [[AutoAnalyzer]] invented in 1957.

==Testing==
<div style="float:right;border:solid 10px white;">{{Blood test sample values}}</div>
Typically, the patient [[fasting|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:<ref name="labtests">{{Cite web |date=2005-10-31 |title=Comprehensive Metabolic Panel |url=http://www.labtestsonline.org/understanding/analytes/cmp/glance.html |access-date=2008-09-22 |publisher=Lab Tests Online}}</ref>

===General tests===
These tests help screen for a wide variety of problems. The [[blood sugar|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.<ref>{{Cite encyclopedia |title=Calcium - blood test |encyclopedia=MedlinePlus Medical Encyclopedia |publisher=Nlm.nih.gov |url=https://www.nlm.nih.gov/medlineplus/ency/article/003477.htm |access-date=2012-09-14 |date=2012-08-27}}</ref>
* [[Serum glucose]]
* [[Calcium in biology|Calcium]]

===Kidney function assessment===
* [[Blood urea nitrogen]] (BUN)
* [[Creatinine]]

===Electrolytes===
[[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]], [[pH|acid-base]] imbalance, or kidney dysfunction.
* [[Sodium]]
* [[Potassium]]
* [[Chloride]]
* [[Carbon dioxide]] (CO<sub>2</sub>)

===Protein tests===
Tests of [[protein]] levels in the blood help screen for both kidney and liver disorders.
* [[Serum total protein]] (TP)
* [[Human serum albumin]]

===Liver enzymes===
* [[Bilirubin]]
* [[Alkaline phosphatase]] (ALP)
* [[Aspartate amino transferase]] (AST or SGOT)
* [[Alanine amino transferase]] (ALT or SGPT)

==Results==

The [[National Institutes of Health]] provides ranges considered within normal limits, though optimal levels may vary by individual.<ref name="nihcmp">{{Cite web |date=2013-01-21 |title=Comprehensive metabolic panel: MedlinePlus Medical Encyclopedia |url=https://www.nlm.nih.gov/medlineplus/ency/article/003468.htm |access-date=2015-04-29 |publisher=NLM.NIH.gov}}</ref>

Compare also the ranges given at ''[[Reference ranges for blood tests]]''.

{| class="wikitable"
|+ Normal CMP Results
! Specimen
! Normal Range<ref name=nihcmp/>
! Units
|-
| [[Human serum albumin|Albumin]]
| 3.9–5.0
| g/dL
|-
| [[Alkaline phosphatase]]
| 44–147
| IU/L
|-
| [[Alanine transaminase|ALT (alanine aminotransferase)]]
| 8–37
| IU/L
|-
| [[Aspartate transaminase|AST (aspartate aminotransferase)]]
| 10–34
| IU/L
|-
| [[BUN|BUN (blood urea nitrogen)]]
| 7–20
| mg/dL
|-
| [[Calcium in biology|Calcium]]
| 8.5–10.9
| mg/dL
|-
| [[Serum chloride|Chloride]]
| 96–106
| mmol/L
|-
| [[Carbon dioxide#Biological role|CO2 (carbon dioxide)]]
| 20–29
| mmol/L
|-
| [[Creatinine]]
| 0.6–1.1 (women)<ref name="nihcreatinine">{{Cite web |date=2013-08-04 |title=Creatinine blood test: MedlinePlus Medical Encyclopedia |url=https://www.nlm.nih.gov/medlineplus/ency/article/003475.htm |access-date=2015-04-29 |publisher=NLM.NIH.gov}}</ref>
0.7–1.3 (men)
| mg/dL
|-
| [[Glucose]]
| 70–100
| mg/dL
|-
| [[Potassium in biology|Potassium]]
| 3.7–5.2
| mEq/L
|-
| [[Sodium in biology|Sodium]]
| 136–144
| mEq/L
|-
| [[Bilirubin|Total bilirubin]]
| 0.2–1.9
| mg/dL
|-
| [[Protein|Total protein]]
| 6.3–7.9
| g/dL
|}

==See also==
* [[Basic metabolic panel]]

==References==
{{reflist}}

==External links==
* [http://labtestsonline.org/tests/comprehensive-metabolic-panel-cmp Labsonline.org: Comprehensive Metabolic Panel]
{{Blood tests}}

[[Category:Blood tests]]