Interpretation of Comprehensive Metabolic Panel Results
The comprehensive metabolic panel shows normal values across all parameters with a sodium level at the upper end of normal range (139 mmol/L) and an eGFR of 88 mL/min/1.73m², which does not require any specific intervention at this time.
Analysis of Key Laboratory Values
Kidney Function Parameters
- eGFR: 88 mL/min/1.73m² (normal ≥60)
- Creatinine: 1.14 mg/dL (normal 0.40-1.30)
- BUN: 15 mg/dL (normal 7-23)
- BUN/Creatinine Ratio: 13.2 (normal 12.0-20.0)
The patient's kidney function appears normal based on these values. According to KDIGO guidelines, an eGFR ≥60 mL/min/1.73m² without other markers of kidney damage is not considered chronic kidney disease 1. The current eGFR of 88 mL/min/1.73m² indicates good kidney function.
Electrolytes
- Sodium: 139 mmol/L (normal 135-145)
- Potassium: 4.7 mmol/L (normal 3.5-5.0)
- Chloride: 100 mmol/L (normal 98-109)
- CO2: 29 mmol/L (normal 20-31)
- Anion Gap: 10 (normal 6-16)
- Calcium: 9.1 mg/dL (normal 8.5-10.5)
All electrolytes are within normal ranges. The sodium level is at the upper end of normal but still within reference range. Research has suggested that higher sodium levels, even within normal range, may be associated with elevated blood pressure and potentially affect kidney function 2, but the current value doesn't warrant specific intervention.
Liver Function Tests
- AST: 13 unit/L (normal 8-43)
- ALT: 10 unit/L (normal 10-65)
- Alkaline Phosphatase: 57 unit/L (normal 38-110)
- Total Bilirubin: 0.6 mg/dL (normal 0.1-1.2)
- Total Protein: 6.9 g/dL (normal 6.0-8.5)
- Albumin: 4.3 g/dL (normal 3.5-5.0)
- Globulin: 2.6 g/dL (normal 2.0-4.0)
All liver function tests are within normal ranges, indicating normal hepatic function.
Glucose
- Glucose: 96 mg/dL (normal 70-100)
The glucose level is within normal range, though at the upper end of normal.
Recommended Management Approach
Immediate Management
- No urgent intervention is required as all values are within normal ranges.
- The D-Dimer test is mentioned in the panel but no result is provided. If this test was ordered due to suspicion of venous thromboembolism, follow-up would depend on the actual result.
Follow-up Recommendations
Routine monitoring of kidney function:
- Annual monitoring of eGFR and urinary albumin-to-creatinine ratio is appropriate for patients with eGFR >60 mL/min/1.73m² 1.
- If the patient has risk factors for kidney disease (diabetes, hypertension), more frequent monitoring may be warranted.
Blood pressure assessment:
- Ensure blood pressure is well-controlled, especially given the sodium level at the upper end of normal.
- According to guidelines, target blood pressure should be <130/80 mmHg for most patients 1.
Lifestyle recommendations:
- Moderate sodium intake (approximately 2.3g/day or less) may be beneficial, especially if there's any tendency toward hypertension 3.
- Maintain adequate hydration.
- Regular physical activity.
Special Considerations
Sodium Level
While the sodium level of 139 mmol/L is within normal range, it's at the upper end. Research has shown that higher sodium levels, even within normal range, may be associated with elevated blood pressure 2. However, a single measurement within normal range doesn't require specific intervention beyond standard lifestyle recommendations.
eGFR Interpretation
The eGFR of 88 mL/min/1.73m² indicates good kidney function. According to KDIGO guidelines, an eGFR ≥60 mL/min/1.73m² without other markers of kidney damage (such as albuminuria) is not considered chronic kidney disease 1.
Common Pitfalls to Avoid
Over-interpreting minor variations within normal range: Laboratory reference ranges are typically established to include 95% of healthy individuals, meaning 5% of healthy people will have values outside the "normal" range 4. Minor variations within the normal range rarely require intervention.
Failing to consider pre-analytical variables: Factors such as hydration status, time of day, recent exercise, and diet can affect laboratory values, particularly electrolytes and kidney function tests.
Not considering the clinical context: Laboratory results should always be interpreted in the context of the patient's clinical presentation, medical history, and other diagnostic findings.
Missing trends over time: A single normal laboratory value provides limited information compared to trends over time. If previous results are available, comparing current values to baseline can be more informative.