Test Id : CMAMA

Ship specimen protected from light.

Patient's age and sex are required.

Supplies: Amber Frosted Tube, 5 mL (T915)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Amber vial

Specimen Volume: 0.6 mL

Collection Instructions:

1. Serum gel tubes should be centrifuged and protected from light within 2 hours of collection.

2. Red-top tubes should be centrifuged, and the serum aliquoted into an amber vial within 2 hours of collection.

0.5 mL

Routine health monitoring

Patient monitoring while hospitalized for information regarding metabolism, including the current kidney status, electrolyte and acid/base balance, and blood glucose

The comprehensive metabolic panel measures 14 analytes and calculates an anion gap. It is used to assess kidney or liver status, electrolyte and acid/base balance, and blood glucose This comprehensive metabolic panel can also provide information about a patient's response to medications that would impact kidney or liver function.

SODIUM

<1 year: Not established

> or =1 year: 135-145 mmol/L

POTASSIUM

<1 year: Not established

> or =1 year: 3.6-5.2 mmol/L

CHLORIDE

1-17 years: 102-112 mmol/L

> or =18 years: 98-107 mmol/L

Reference values have not been established for patients who are younger than 12 months of age.

BICARBONATE

Males

12-24 months: 17-25 mmol/L

3 years: 18-26 mmol/L

4-5 years: 19-27 mmol/L

6-7 years: 20-28 mmol/L

8-17 years: 21-29 mmol/L

> or =18 years: 22-29 mmol/L

Females

1-3 years: 18-25 mmol/L

4-5 years: 19-26 mmol/L

6-7 years: 20-27 mmol/L

8-9 years: 21-28 mmol/L

> or =10 years: 22-29 mmol/L

Reference values have not been established for patients that are younger than 12 months of age.

ANION GAP

> or =7 years: 7-15

Reference values have not been established for patients who are younger than 7 years of age.

BLOOD UREA NITROGEN (BUN)

Males

1-17 years: 7-20 mg/dL

> or =18 years: 8-24 mg/dL

Reference values have not been established for patients who are younger than 12 months of age.

Females

1-17 years: 7-20 mg/dL

> or =18 years: 6-21 mg/dL

Reference values have not been established for patients who are younger than 12 months of age

CREATININE

Males:

0-11 months: 0.17-0.42 mg/dL

1-5 years: 0.19-0.49 mg/dL

6-10 years: 0.26-0.61 mg/dL

11-14 years: 0.35-0.86 mg/dL

> or =15 years: 0.74-1.35 mg/dL

Females:

0-11 months: 0.17-0.42 mg/dL

1-5 years: 0.19-0.49 mg/dL

6-10 years: 0.26-0.61 mg/dL

11-15 years: 0.35-0.86 mg/dL

> or =16 years: 0.59-1.04 mg/dL

ESTIMATED GLOMERULAR FILTRATION RATE (eGFR)

>= 18 years old: > or =60 mL/min/BSA

Estimated GFR calculated using the 2021 CKD_EPI creatinine equation.

Note: eGFR results will not be calculated for patients younger than 18 years old.

CALCIUM

<1 year: 8.7-11.0 mg/dL

1-17 years: 9.3-10.6 mg/dL

18-59 years: 8.6-10.0 mg/dL

60-90 years: 8.8-10.2 mg/dL

>90 years: 8.2-9.6 mg/dL

GLUCOSE

0-11 months: Not established

> or =1 year: 70-140 mg/dL

TOTAL PROTEIN

> or =1 year: 6.3-7.9 g/dL

Reference values have not been established for patients who are younger than 12 months of age.

ALBUMIN

> or =12 months: 3.5-5.0 g/dL

Reference values have not been established for patients who are younger than 12 months of age.

ASPARTATE AMINOTRANSFERASE (AST)

Males:

0-11 months: Not established

1-13 years: 8-60 U/L

> or =14 years: 8-48 U/L

Females:

0-11 months: Not established

1-13 years: 8-50 U/L

> or =14 years: 8-43 U/L

ALKALINE PHOSPHATASE (ALP)

Males

0-14 days: 83-248 U/L

15 days-<1 year: 122-469 U/L

1-<10 years: 142-335 U/L

10-<13 years: 129-417 U/L

13-<15 years: 116-468 U/L

15-<17 years: 82-331 U/L

17-<19 years: 55-149 U/L

> or =19 years: 40-129 U/L

Females

0-14 days: 83-248 U/L

15 days-<1 year: 122-469 U/L

1-<10 years: 142-335 U/L

10-<13 years: 129-417 U/L

13-<15 years: 57-254 U/L

15-<17 years: 50-117 U/L

> or =17 years: 35-104 U/L

ALANINE AMINOTRANSFERASE (ALT)

Males:

> or =1 year: 7-55 U/L

Reference values have not been established for patients who are younger than 12 months of age.

Females:

> or =1 year: 7-45 U/L

Reference values have not been established for patients who are younger than 12 months of age.

TOTAL BILIRUBIN

0-6 days: Refer to www.bilitool.org for information on age-specific (postnatal hour of life) serum bilirubin values.

7-14 days: 0.0-14.9 mg/dL

15 days to 17 years: 0.0-1.0 mg/dL

>18 years 0.0-1.2 mg/dL

Comprehensive metabolic panel results are usually evaluated in conjunction with each other for patterns of results. The pattern of abnormal results can help identify the possible conditions or diseases present. Many conditions will cause abnormal results including kidney failure, breathing problems, and diabetes-related complications.

No significant cautionary statements

Comprehensive Metabolic Panel (CMP). Testing.com; Updated July 29, 2022. Accessed September 19, 2023. Available at www.testing.com/tests/comprehensive-metabolic-panel-cmp/

Sodium, Potassium, Chloride:

Ion-selective electrode (ISE) (indirect potentiometry). The ion selective electron (ISE) module indirectly measures the electromotive force (EMF) difference between an ISE and a reference electrode.  The EMF of the ion-selective electrode is dependent on the ion concentration of the sample. The EMF of the reference electrode is constant. An electronic calculation circuit converts EMF of the sample to the ion concentration of the sample.(Package insert: ISE Indirect Na, K, CL for Gen2. Roche Diagnostics; 12/2020)

Bicarbonate:

This is a photometric rate reaction. Bicarbonate (HCO3-) reacts with phosphoenolpyruvate (PEP) in the presence of phosphoenolpyruvate carboxylase (PEPC) to produce oxaloacetate and phosphate. The oxaloacetate produced is coupled with NADH in the presence of malate dehydrogenase (MDH) to produce malate and NAD. The consumption of NADH causes a decrease in absorbance and is monitored in the UV range of 320 nm to 400 nm. The rate of change is directly proportional to the concentration of bicarbonate.(Package insert: Bicarbonate reagent Roche Diagnostics; 04/2019)

Anion Gap:

This is a calculated result. The following equation is used to calculate the anion gap (A gap):

A gap =Na - (Cl + HCO3-)

Blood Urea Nitrogen:

This is a kinetic UV assay where urease cleaves urea to form ammonia and carbon dioxide. The ammonia formed then reacts with alpha-ketoglutarate and NADH in the presence of urease/glutamate dehydrogenase to yield glutamate and NAD+. The decrease in absorbance, due to the consumption of NADH, is measured kinetically and is proportional to the amount of urea in the sample.(Package insert: Urea/BUN reagent. Roche Diagnostics; 12/2019)

Creatinine:

This enzymatic method is based on the conversion of creatinine with the aid of creatininase, creatinase, and sarcosine oxidase to glycine, formaldehyde, and hydrogen peroxide. Catalyzed by peroxidase the liberated hydrogen peroxide reacts with 4-aminophenazone and HTIB (hydroxy[tosyloxy]iodobenzene) to form a quinone imine chromogen. The color intensity of the quinone imine chromogen formed is directly proportional to the creatinine concentration in the reaction mixture.(Package insert: Creatinine. Roche Diagnostics; 02/2019)

Calcium:

Calcium ions react with NM-BAPTA (5-nitro-5'-methyl-1,2-bis[o-aminophenoxy]ethane-N,N,N',N'-tetraacetic acid) under alkaline conditions to form a complex. This complex reacts in the second step with EDTA. The change in absorbance is directly proportional to the calcium concentration and is measured photometrically.(Package insert: Calcium Gen.2 reagent. Roche Diagnostics; 07/2019)

Glucose:

Glucose in the serum, in the presence of hexokinase, is converted to glucose-6-phosphate (G6P). In the presence of nicotinamide adenine dinucleotide phosphate (NADP+), glucose-6-phosphate dehydrogenase oxides G6P to gluconate-6-phosphate and NADPH. The rate of NADPH formation is directly proportional to glucose concentration and is measured photometrically.(Package insert: Glucose HK Gen.3 Reagent. Roche Diagnostics; 11/2021)

Total Protein:

Divalent copper reacts in alkaline solution with protein peptide bonds to form the characteristic purple-colored biuret complex. Sodium potassium tartrate prevents the precipitation of copper hydroxide and potassium iodide prevents autoreduction of copper. The color intensity is directly proportional to the protein concentration, which can be determined photometrically.(Package insert: Total Protein Gen.2 reagent, Roche Diagnostics; 11/2019)

Albumin:

The dye, bromcresol green (BCG), is added to serum in an acid buffer. The color intensity of the blue-green albumin-BCG complex is directly proportional to the albumin concentration and is determined photometrically.(Package insert: Albumin Gen.2 reagent. Roche Diagnostics; 02/2022)

Aspartate Aminotransferase:

Aspartate aminotransferase (AST) is measured by a coupled enzyme kinetic method where the rate of decrease of NADH, determined at 340 nm, is directly proportional to the AST activity.(Package insert: AST reagent. Roche Diagnostics; 02/2022)

Alkaline Phosphatase:

In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. The p-nitrophenol released is directly proportional to the catalytic alkaline phosphatase activity. It is determined by measuring the increase in absorbance.(Package insert: Alkaline Phosphatase Gen.2 reagent. Roche Diagnostics; 04/2019)

Alanine Aminotransferase:

Alanine aminotransferase (ALT) activity is determined by a kinetic method using a coupled enzyme reaction where the rate of NADH consumption is measured at 340 nm. The NADH decrease is directly proportional to the ALT activity.(Package insert: ALT reagent. Roche Diagnostics; 11/2021)

Total Bilirubin:

Total bilirubin, in the presence of a suitable solubilizing agent, is coupled with 3,5-dichlorophenyl diazonium in a strongly acidic medium. The color intensity of the red azo dye formed is directly proportional to the total bilirubin and can be determined photometrically.(Package insert: Bilirubin Total Gen. 3. Roche Diagnostics; 01/2020)

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This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

KS-84132

NAS-84295

CL-82435

HCO3-82374

BUN-84520

CRTS1-82565

CA-82310

GLURA-82947

TP-84155

ALB-82040

AST-84450

ALP-84075

ALT-84460

BILIT-82247