What tests are included in a Comprehensive Metabolic Panel (CMP)?

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What Tests Are Included in a Comprehensive Metabolic Panel (CMP)

A Comprehensive Metabolic Panel (CMP) includes 14 tests: glucose, calcium, sodium, potassium, chloride, bicarbonate (CO2), blood urea nitrogen (BUN), creatinine, albumin, total protein, alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin.

Components of the CMP

The CMP is routinely measured as part of the basic metabolic panel and provides comprehensive assessment of metabolic and organ function. Based on multiple clinical guidelines, the CMP consistently includes:

Electrolytes (4 tests):

  • Sodium
  • Potassium
  • Chloride
  • Bicarbonate (CO2)

Kidney Function Tests (2 tests):

  • Blood Urea Nitrogen (BUN)
  • Creatinine (with calculated estimated glomerular filtration rate/eGFR)

Liver Function Tests (4 tests):

  • Alanine aminotransferase (ALT)
  • Aspartate aminotransferase (AST)
  • Alkaline phosphatase (ALP)
  • Total bilirubin

Protein Tests (2 tests):

  • Total protein
  • Albumin

Additional Tests (2 tests):

  • Glucose
  • Calcium

Clinical Context

The CMP is referenced across multiple clinical guidelines for baseline assessment and monitoring 1, 2, 3, 4, 5, 6, 7. The 2024 KDIGO guidelines specifically note that creatinine is measured routinely as part of the basic metabolic panel 8, while the 2018 ACC/AHA hypertension guidelines indicate that fasting blood glucose, serum creatinine with eGFR, and serum sodium, potassium, and calcium "may be included in a comprehensive metabolic panel" 4.

The 2024 ADA diabetes guidelines list the CMP among essential laboratory studies, noting it "includes serum blood urea nitrogen/creatinine, electrolytes, albumin, calcium, and liver function tests to assess kidney and liver function" 7.

Distinction from Basic Metabolic Panel (BMP)

The BMP contains only 8 tests (the electrolytes, kidney function tests, glucose, and calcium), while the CMP adds the 6 additional tests for liver and protein assessment 9, 10. The cost difference is approximately $21 between BMP and CMP 10.

References

Guideline

hyperglycemic crises in diabetes.

Diabetes Care, 2004

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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