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.

If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

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:

An ion-selective electrode (ISE) makes use of the unique properties of ion-selective membrane to develop an electrical potential (electromotive force, EMF) for the measurements of ions in solution. Selective membrane is in contact with both the test solution and an internal filling solution. Due to the selectivity of the membrane, only the ions to be measured contribute to the EMF. The membrane EMF is determined by the difference in concentration of the test ion in the test solution and the internal filling solution. The EMF develops according to Nernst equation of a specific ion in solution.(Package insert: ISE indirect Na-K-Cl for Gen 2. Roche Diagnostics; 05/2024)

Bicarbonate:

Bicarbonate reacts with phosphoenolpyruvate (PEP) in the presence of PEPC to produce oxaloacetate and phosphate. That reaction is coupled with one involving the transfer of a hydrogen ion from reduced nicotinamide adenine dinucleotide (NADH) analog to oxaloacetate using malate dehydrogenase (MDH). The resultant consumption of NADH analog causes a decrease in absorbance, which is proportional to the concentration of bicarbonate in the sample being analyzed.(Package insert: Bicarbonate reagent. Roche Diagnostics; 02/2023)

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:

Kinetic test with urease and glutamate dehydrogenase. Urea is hydrolyzed by urease to form ammonium and carbonate. In the second reaction 2-oxoglutarate reacts with ammonium in the presence of glutamate dehydrogenase and the coenzyme NADH to produce L-glutamate. In this reaction two moles of NADH are oxidized to NAD[+] for each mole of urea hydrolyzed. The rate of decrease in NADH concentrations is directly proportional to the urea concentration in the specimen and is measured photometrically.(Package insert: Urea/BUN reagent. Roche Diagnostics; 07/2024)

Creatinine:

This enzymatic method is based on the conversion of creatinine with the aid of creatininase, creatinase, and sarcosine oxidase to form glycine, formaldehyde, and hydrogen peroxide. Catalyzed by peroxidase the liberated hydrogen peroxide reacts with 4-aminophenazone and HTIB (2,4,6-triiodo03-hydroxybenzoic acid) 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 plus ver.2. Roche Diagnostics; 07/2024)

Calcium:

Calcium ions react with 5-nitro-5'-methyl-BAPTA (NM-BAPTA) 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: CA2 reagent. Roche Diagnostics; 08/2023)

Glucose:

Hexokinase catalyzes the phosphorylation of glucose to glucose-6-phosphate by ATP. Glucose-6-phosphate dehydrogenase oxidizes glucose-6-phosphate in the presence of nicotinamide adenine dinucleotide phosphate (NADP) to gluconate-6-phosphate. No other carbohydrate is oxidized. The rate of NADPH formation during the reaction is directly proportional to the glucose concentration and is measured photometrically.(Package insert: Glucose HK Gen.3. Roche Diagnostics; 07/2024)

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; 09/2023)

Albumin:

At a pH value of 4.1, albumin displays a sufficiently cationic character to be able to bind with bromcresol green (BCG), an anionic dye, to form a blue-green complex. The color intensity of the blue-green color is directly proportional to the albumin concentration in the sample and is measured photometrically.(Package insert: Albumin reagent. Roche Diagnostics; 06/2024)

Aspartate Aminotransferase:

Aspartate aminotransferase (AST) catalyzes the transfer of an amino group between L-aspartate and 2-oxoglutarate to form oxaloacetate and L-glutamate. The oxaloacetate then reacts with NADH, in the presence of MDH to form L-malate and NAD[+]. Pyridoxal phosphate serves as a coenzyme in the amino transfer reaction. It ensures full enzyme activation. The rate of NADH oxidation is directly proportional to the catalytic AST activity. It is determined by measuring the decrease in absorbance.(Package insert: Aspartate Aminotransferase reagent. Roche Diagnostics; 01/2024)

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 reagent. Roche Diagnostics; 09/2022)

Alanine Aminotransferase:

Alanine aminotransferase (ALT) catalyzes the transfer of an amino group between L-alanine and 2-oxoglutarate to form pyruvate and L-glutamate. The pyruvate then reacts with NADH in the presence of lactate dehydrogenase to form L-lactate and NAD[+]. Pyridoxal phosphate serves as a coenzyme in the amino transfer reaction. It ensures full enzyme activation. The rate of NADH oxidation is directly proportional to the catalytic ALT activity. It is determined by measuring the decrease in absorbance.(Package insert: ALT reagent. Roche Diagnostics; 04/2024)

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; 01/2024)

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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