Comprehensive Metabolic Panel (CMP) Components
A Comprehensive Metabolic Panel (CMP) includes 14 tests measuring kidney function, electrolytes, glucose, and liver function: sodium, potassium, carbon dioxide, chloride, blood urea nitrogen (BUN), creatinine, glucose, calcium, albumin, total protein, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, and bilirubin. 1
Core Components Breakdown
The CMP consists of all components found in a Basic Metabolic Panel (BMP) plus additional liver function tests 2:
Electrolytes
- Sodium - assesses fluid balance and kidney function 1, 3
- Potassium - evaluates electrolyte balance and cardiac function 1, 3
- Chloride - measures acid-base balance 1, 3
- Carbon dioxide (CO2) - assesses respiratory and metabolic function 1, 3
Kidney Function Tests
- Blood urea nitrogen (BUN) - evaluates kidney function and protein metabolism 1, 3
- Creatinine - measures kidney filtration capacity 1, 3
- Elevated BUN and creatinine indicate impaired kidney function 3
Glucose Metabolism
Mineral Balance
- Calcium - assesses bone health, parathyroid function, and electrolyte balance 3
Liver Function Tests (What Distinguishes CMP from BMP)
- Aspartate aminotransferase (AST) - liver enzyme indicating hepatocellular injury 1
- Alanine aminotransferase (ALT) - more specific liver enzyme for hepatic damage 1, 2
- Alkaline phosphatase - evaluates bile duct function and bone disorders 1
- Total bilirubin - measures liver's ability to process waste products 1, 2
- Albumin - assesses liver synthetic function and nutritional status 1
- Total protein - evaluates overall protein status and liver function 1
Clinical Applications
The CMP is recommended for comprehensive metabolic assessment in multiple clinical scenarios 2:
- Initial cancer workup including renal cell carcinoma and myeloproliferative neoplasms 1, 2
- Acute stroke evaluation to identify underlying metabolic conditions 2
- Suspected liver disease in patients with right upper quadrant pain, jaundice, hepatomegaly, or ascites 2
- Multisystem inflammatory syndrome in children (MIS-C) as part of tier 1 screening 1
- Tumor lysis syndrome monitoring requiring comprehensive metabolic status assessment 2
Important Distinction
The CMP does not include a lipid panel - lipid testing (total cholesterol, LDL, HDL, triglycerides) requires separate ordering 2. This is a common point of confusion in clinical practice.