Comprehensive Metabolic Panel (CMP)

What

Includes 14 tests: ALP, ALT, AST, bilirubin, BUN, creatinine, sodium, potassium, carbon dioxide, chloride, albumin, total protein, glucose, and calcium.

Who

Must be 18+ years of age to purchase.

How

Blood

Where

Find a location near you

Schedule an appointment, then visit a Quest Diagnostics patient service center location.

About the Test

This test measures the blood levels of the following components in the body: blood sugar (glucose), calcium, total protein, liver enzymes (alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase), bilirubin, blood urea nitrogen, creatinine, albumin, carbon dioxide, and the electrolytes sodium, potassium, and chloride. An abnormal CMP result, or a combination of abnormal CMP results, may indicate various health conditions, such as liver or kidney disease, hypertension, or diabetes.

This test is a useful tool containing routine screening tests that may help healthcare providers identify signs of certain medical conditions, such as kidney or liver disease, diabetes, hypertension, and other health conditions.

Blood glucose is the primary sugar found in your bloodstream. The sugar mainly comes from the food you eat and supplies energy to all cells in the body. High glucose levels may increase the risk of diabetes and associated disorders, such as heart disease.

Calcium is one of the most abundant minerals in the human body and plays a key role in multiple bodily functions. Most of the calcium in your body is stored in your bones, with only 1% circulating in your bloodstream. Calcium is required for strong bones and teeth and proper nerve, muscle, and heart function. Abnormally high or low calcium levels in the blood may be a sign of bone disease, kidney disorders, thyroid disease, or other conditions.

The total protein test measures the total amount of 2 types of proteins found in your blood, albumin and globulin. Abnormal total protein levels may be a sign of nutritional abnormalities, liver disease, or kidney dysfunction.

Alanine aminotransferase (ALT) is an enzyme found primarily in the liver and, to a lesser degree, the muscles, heart, kidneys, and pancreas. ALT helps the liver break down proteins, increasing your body's ability to absorb them. High ALT levels may be a sign of liver damage or a liver condition.

Aspartate aminotransferase (AST) is an enzyme found primarily in the liver, but also in other tissues, including the muscles, brain, heart, kidneys, pancreas, and red blood cells. AST, which plays a key role in breaking down proteins for energy production, is released into the blood when such tissues are damaged. High AST levels may be a sign of damage to the liver or other tissues The CMP will also include a ratio of concentrations of AST and ALT (AST/ALT ratio), which may be used by healthcare providers to differentiate between possible causes of liver disease or damage.

Alkaline phosphatase (ALP) is an enzyme found throughout the body, primarily in the liver and bones, that plays a key role in breaking down proteins. ALP blood tests determine the ALP levels from the liver and bones, where high levels may be a sign of liver disease or specific bone disorder.

Bilirubin is a waste product produced during the normal breakdown of red blood cells. It is a yellowish substance found in bile, a fluid produced and released by the liver. Bilirubin passes through the liver and is eventually excreted out of the body. High levels of bilirubin may be a sign of the liver not functioning correctly.

Blood urea nitrogen (BUN) is a form of nitrogen found in urea, a waste product created during protein metabolism. As proteins are broken down into amino acids, these amino acids are then broken down and converted into ammonia, which the liver then converts into a less toxic substance called urea. Urea is transported through the bloodstream to the kidneys, where it is filtered and eliminated from the body through urine. Abnormally high blood levels of BUN may be a sign of kidney (renal) damage or disease.

The liver produces creatine, which the muscles use as an energy source. During normal muscular use, some creatine will be broken down into creatinine by the muscles as a waste product. Creatinine is transported through the bloodstream to the kidneys, where it is filtered and eliminated from the body through urine. An abnormally high creatinine level may suggest damage to the kidneys or renal blood vessels The CMP also includes a calculation called an estimated glomerular filtration rate (eGFR), which measures how much blood the tiny renal filters (glomeruli) remove every minute based on your body size. The eGFR indicates how efficiently the kidneys remove toxins and excess fluid from the blood. In addition, the CMP includes a BUN/Creatinine ratio—which, if elevated, may suggest a condition that causes decreased blood flow to the kidneys, such as dehydration or congestive heart failure.

Albumin is a protein produced by the liver that helps keep fluid within the bloodstream rather than leaking into other tissues. The primary function of albumin is to transport hormones, vitamins, and enzymes throughout the body.

Carbon dioxide (CO2) is an odorless, colorless gas that your body produces when it breaks down food for energy. As you inhale oxygen, the blood transports carbon dioxide to the lungs for removal through exhalation. Most carbon dioxide in the blood is in the form of bicarbonate. Although carbon dioxide plays various roles in the body, bicarbonate is critical for maintaining a balanced pH in the blood that is neither too acidic nor too basic (alkaline).

Chloride is an electrolyte that helps to balance fluids inside and outside of your body's cells. Chloride plays an essential role in metabolism and is also instrumental in maintaining proper blood volume, blood pressure, anPotassium and sodium: Potassium and sodium electrolytes work in tandem to help maintain fluid balance and blood volume, nerve and muscle growth, heart function, and pH balance in the body. Potassium is obtained from the foods you eat and is present in all bodily tissues; sodium also comes from your diet. Having insufficient potassium and too much sodium may lead to hypertension.

You must be 18 years of age or older to purchase. Purchases not permitted in: AK, AZ, HI.

Overnight fasting is required for this panel (10-12 hours without food).

When your results are ready, we will send them to you in a clear, easy-to-read report. You will have the option to speak with an independent physician to discuss your results. If your results differ from expected ranges, you may receive an alert call to inform you.Your test results will be available to you a few days after we collect your sample.

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Your results are available on our free, secure patient portal that you can access on your smartphone, tablet, or desktop. You will receive an email notification when your results are ready. You can also share your results with your healthcare provider, family, or friends.

FAQs

Are there other names for a Comprehensive Metabolic Panel?

Yes, a Comprehensive Metabolic Panel is also known as chem 14, chemistry panel, chemistry screen, CMP, and metabolic panel.

What components are evaluated to determine liver health and why?

The liver uses enzymes to break down toxic substances so the body can safely process them. When liver cells are damaged or inflamed, their enzymes leak into the bloodstream, raising liver enzyme levels in the blood. Alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and bilirubin are enzymes found in the liver. These enzymes are measured to evaluate liver health and determine how well your liver performs its normal functions.

How is total protein measured?

Albumin, together with globulin, forms the total protein level on the Comprehensive Metabolic Panel. Globulins are critical for liver function, blood clotting, moving nutrients throughout the body, and fighting infection. Some globulins are produced by the liver; others are made by the immune system in response to an infection or an allergic reaction.

Along with total protein, the CMP indicates the ratio of albumin to globulin (A/G ratio) to detect whether your protein level is abnormal. If your total protein level and A/G ratio are abnormal, this may indicate that your body is not digesting or absorbing proteins properly or that your kidney or liver are not functioning correctly. If your A/G ratio is excessively high or low, further blood and urine testing may be suggested.

What are the markers of kidney health on the CMP?

Creatinine, BUN, and estimated glomerular filtration rate (eGFR) provide information about the overall health of the kidneys. The kidneys filter creatinine and BUN from the blood and remove them from the body. An eGFR measures how much blood the renal glomeruli remove every minute based on your body size, indicating how efficiently the kidneys are functioning.

In addition, a CMP includes a BUN/Creatinine ratio—which, if elevated, may suggest a condition that causes decreased blood flow to the kidneys, such as dehydration or congestive heart failure.

What are electrolytes and which ones are tested?

Electrolytes are electrically charged minerals consumed through food and drink. Your kidneys tightly regulate and balance water, pH (acid/base, the ratio of acids to bases in the body), and electrolyte levels in your body, which are essential for the proper functioning of your nerves, muscles, heart, and brain.

Are table salt and sodium the same?

Although commonly used interchangeably, salt and sodium are not the same. Table salt is sodium chloride, a crystal-like type of sodium obtained through the diet. Sodium is a mineral needed by the body in relatively small amounts and one of the chemical elements found in salt. More than 70 percent of dietary sodium is obtained through packaged and prepared foods, not from table salt added while preparing or eating food.

Our references

FDA. Sodium in your diet. www.fda.gov/food/nutrition-education-resources-materials/sodium-your-diet