What is included in a Comprehensive Metabolic Panel (CMP)?

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From the Guidelines

A Comprehensive Metabolic Panel (CMP) includes measurements of glucose, electrolytes, kidney function tests, liver function tests, and proteins to evaluate organ function and check for conditions like diabetes, liver disease, and kidney disease. The CMP consists of various components, such as:

  • Glucose (blood sugar) levels to screen for diabetes
  • Electrolytes (sodium, potassium, chloride, carbon dioxide) to assess fluid and electrolyte balance
  • Kidney function tests (BUN and creatinine) to evaluate how well the kidneys filter waste
  • Liver function tests (ALT, AST, alkaline phosphatase, bilirubin) to check liver health and function
  • Proteins (albumin and total protein) to assess nutritional status and liver function 1. This panel provides a broad overview of metabolic and chemical balance in the body, and is typically ordered as part of a routine physical examination or when monitoring chronic conditions, requiring fasting for 8-12 hours before the blood draw to ensure accurate results, particularly for glucose levels. The most recent and highest quality study, published in 2024, supports the inclusion of these measurements in a CMP 1. Key points to consider when interpreting CMP results include:
  • Abnormal glucose levels may indicate diabetes or pre-diabetes
  • Electrolyte imbalances can indicate fluid or electrolyte disorders
  • Abnormal kidney function tests can indicate kidney disease or damage
  • Abnormal liver function tests can indicate liver disease or damage
  • Abnormal protein levels can indicate nutritional deficiencies or liver disease.

From the Research

Components of a Comprehensive Metabolic Panel (CMP)

A CMP is a group of tests used to evaluate various aspects of a person's metabolism and overall health. The components of a CMP may include:

  • Electrolyte balance tests, such as sodium and potassium levels 2
  • Kidney function tests, including:
    • Serum creatinine levels, which are used to estimate glomerular filtration rate (GFR) 3, 2
    • Urea levels, which can help diagnose acute kidney failure 2
  • Other tests to evaluate liver function, blood sugar control, and fluid balance

Interpretation of CMP Results

When interpreting CMP results, it is essential to consider the pathophysiology and reference intervals of each parameter 2. For example:

  • Serum creatinine levels can be affected by non-renal determinants, such as muscle mass and age, which can lead to overestimation of GFR in certain populations 2
  • Electrolyte imbalances, such as hyponatremia, can be caused by excess water or other underlying conditions 2

Limitations of CMP Components

The use of serum creatinine as a marker of kidney function has substantial shortcomings, including limitations in accurately estimating static kidney function and detecting changes in kidney function 3. Alternative functional biomarkers of the kidney may be used to provide additional information 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Creatinine: From physiology to clinical application.

European journal of internal medicine, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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