Comprehensive Metabolic Panel (CMP)

Also Known As CMP, Metabolic Panel, Chem 8, Chem 14, Renal Panel, Chemistry Panel

A comprehensive metabolic profile (CMP) is a set of blood tests run on a single sample that doctors commonly draw alongside a complete blood count and urinalysis.

Sometimes a thyroid test is done as well to get a picture of a man’s hormone function.

When the doctor looks at your CMP report, he organizes it in his mind according to body systems or possible diseases.

The doctor measures the salt and acid-base balance of the body through:

  • Sodium (Na)
  • Potassium (K)
  • Chloride (Cl)
  • Total carbon dioxide (CO2)


  • A glucose level can help diagnose diabetes.
  • BUN, creatinine, and the BUN-to-Creatinine ratio refers to kidney function. It can also give an idea about water balance and possible heart function.
  • Calcium and Phosphorus give information on an endocrine disorder called hypoparathyroidism. It can also provide information on possible bone disease and malabsorption.
  • The total protein, albumin, and globulin are related to liver/kidney problems and your immune system.
  • Total direct bilirubin can be abnormal in blood and liver disease.
  • The alkaline phosphatase LDH, AST, ALT, and GGT can be abnormal in liver disease.

Now let’s look at these individual tests in more detail.

Glucose Serum

Serum glucose is one of the markers doctors use to diagnose diabetes. It tells about:

  • Increase in Diabetes
  • The decrease in low blood sugar (hypoglycemia)

Note: It takes multiple abnormal glucose results to indicate disease process.

Uric Acid (Serum)

Doctors used Uric acid to help diagnose Gout.

Blood Urea Nitrogen (BUN)

Blood Urea Nitrogen can be abnormal due to:

  • Kidney disease
  • Dehydration
  • Heart failure
  • Malnutrition (In some instances)
  • Liver disease

Creatinine Serum

Serum creatinine is closely related to kidney function.

BUN/Creatinine Ratio

The BUN/Creatinine Ratio can give information on the possible cause of kidney dysfunction. This includes:

  • Heart failure
  • Dehydration
  • Decreased kidney blood flow

Sodium (Serum)

Serum Sodium (Na) can be increased in dehydration. It can be decreased in diuretic therapy and in the syndrome of inappropriate antidiuretic hormone (SIADH)

Potassium (Serum)

The serum potassium tells about:

  • Increase in adrenal insufficiency
  • Acute renal failure

With an inappropriate combination of medications, potassium could be decreased in:

  • Primary aldosteronism
  • Diuretic therapy
  • Renal tubular acidosis

Chloride (Serum)

The serum chloride diagnoses:

  • Increase in dehydration
  • Renal tubular acidosis

It can be low in both congestive heart failure (CHF) and in primary aldosteronism.

Carbon Dioxide (CO2)

Carbon dioxide is most commonly increased in primary pulmonary disease, such as:

  • Primary aldosteronism
  • Severe COPD

It is often found to be decreased in metabolic acidosis like in situations of diabetic ketoacidosis (DKA)

Calcium (Serum)

The serum calcium can be increased in primary hyperthyroidism, which is a type of endocrine disorder. It can also be elevated in malignancy.

Often, when a person has high serum calcium unexpectedly, it’s merely due to hyperparathyroidism.

You can also have a decreased serum calcium in disorders like hypoparathyroidism and in vitamin D deficiency.

Phosphorus (Serum)

The serum phosphorus can be increased due to:

  • Acute or chronic renal failure

It can be decreased in:

  • Malabsorption
  • Vitamin D deficiency

Total Serum Protein

The total serum protein is often increased in:

  • Multiple myeloma
  • Sarcoidosis

It can be decreased in:

  • Chronic glomerulonephritis (A type of chronic renal disease)

Albumin (Serum)

Serum albumin is involved with a plethora of metabolic processes. It is often decreased in the liver disease cirrhosis and in other dysfunctions such as nephrotic syndrome.

Globulin (Total)

The total globulin and the albumen/ globulin ratio can be increased or decreased due to several causes. There’s a special visit for the albumen globulin medical lab test.

Bilirubin (Total)

The total bilirubin can be increased in:

  • Hepatitis
  • Hemolytic Anemia
  • Bile duct blockage

That’s cholestasis or biliary obstruction.

Direct bilirubin is increased related to the same metabolic dysfunction seen in total bilirubin. It’s a helpful lab because the ratio to total bilirubin gives you better insight into what’s causing bilirubin to be elevated in the first place.

One common cause of a slightly elevated total bilirubin is Gilbert’s disease.

Alkaline Phosphate (Serum)

Alkaline phosphatase can be increased in:

  • Bone disease
  • Liver disease

It can be decreased in:

  • Malnutrition
  • Celiac disease

LDH (Lactate Dehydrogenase)

The LDH lactate dehydrogenase can be increased in several diseases, including:

  • Heart disease
  • Liver disease
  • Pernicious anemia
  • Hemolytic anemia folate deficiency
  • Sarcoidosis
  • Pulmonary embolism (PE)
  • Malignant tumors
  • Muscle disease
  • Kidney disease

Liver Enzyme Tests

AST, ALT, and GGT don’t measure liver function but rather give evidence of liver damage.

Interestingly enough, these enzymes can also be elevated in damage to other parts of the body besides just the liver.

These can be increased in:

  • Liver disease
  • Muscle disease
  • Pancreatitis

GGT elevation is commonly seen in alcoholism.

Note: Blood sample is taken. Fast for 12 hours before the test!

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Kind Regards,
David, RN, CCRN
Founder of AndrogenHacker

David Becker, RN, CCRN
David Becker, RN, CCRN Mr. Becker is a father, husband, and CCRN in Trauma ICU. You can read his inspiring comeback story From 412ng/dl To 923ng/dl In 6 Months - Without TRT. Feel free to send David a message here.