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"Clinical Use Detect chronic kidney disease (CKD) in adults Monitor CKD therapy and/or progression in adults Clinical Background About 37 million people in the United States are currently affected by CKD, and the prevalence of ensuing kidney failure is rising.1 Since evidence has shown that treatment at earlier stages is generally effective in preventing or delaying adverse outcomes, monitoring patients with and at risk for CKD becomes critically important for decreasing morbidity and mortality. The Kidney Disease Improving Global Outcomes (KDIGO) guideline defines CKD by the presence of glomerular filtration rate (GFR) <60 mL/min/1.73m2 for >3 months and/or evidence of kidney damage (eg, structural abnormalities, histologic abnormalities, albuminuria, urinary sediment abnormalities, renal tubular disorders, and/or history of kidney transplantation) for >3 months.2 Thus, monitoring should include tests for GFR, albuminuria, and urine sediment. GFR has traditionally been estimated based on 24-hour creatinine clearance; however, a calculation of estimated glomerular filtration rate (eGFR) is now recommended by the National Institutes of Health (NIH) and the National Kidney Foundation. eGFR based on serum creatinine and/or cystatin C is a simpler and generally more reliable test." Includes Albumin, Albumin/Globulin Ratio (calculated), Alkaline Phosphatase, ALT, AST, BUN/Creatinine Ratio (calculated), Calcium, Calcium (adjusted for albumin), Carbon Dioxide, Chloride, Creatinine with GFR Estimated, Globulin (calculated), Glucose, Potassium, Sodium, Total Bilirubin, Total Protein, Urea Nitrogen Patient Preparation Fasting specimen is preferred Methodology See individual tests Reference Range(s) See Laboratory Report
Comprehensive Metabolic Panel (CMP) What is a Comprehensive metabolic panel (CMP)? A comprehensive metabolic panel (CMP) is a test used to determine the overall health conditions of a person. A CMP test helps assess the metabolism and chemicals in the body. It is a significant test for screening and diagnosing many diseases, such as kidney, liver, diabetes, or high blood pressure. Your doctor may recommend the test when you are dealing with muscle weakness, muscle aches, or when the color of your urine is dark. You may also order this test if you are using specific medicines that show side effects on your health. What are the components of the CMP test? A CMP test is a sequence of tests that measure 14 different substances in your body. These include Glucose – It is a significant source of energy for your body. Glucose is a type of blood sugar. Its high level may lead to diabetes. Calcium – An essential mineral for the development of bones and teeth. Large quantities of calcium deposit in your bones, but your blood needs it too. Calcium helps regulate the nerves, heart, and muscles. It utilizes for blood clotting. Liver tests Four liver components are part of a CMP test, in which three of them are enzymes. Alanine aminotransferase (ALP, SGPT) Alkane phosphate (ALP) Aspartate aminotransferase (ATI, SGOT) The above three enzymes are present in the liver, kidney, and heart. Enzymes are substances that work as a catalyst and help in the function of metabolism. Bilirubin – It is a waste chemical produced due to the decomposition of red blood cells in the liver. Your liver removes the bilirubin from your body. Electrolyte tests A comprehensive metabolic panel test also determines the levels of electrolytes in your blood. Electrolytes are minerals found in the blood as dissolved salts and are responsible for converting nutrients to cells. They also eliminate waste from the body and maintain the acid-base balance (pH balance). Here are four electrolyte components as follows: Sodium – Sodium maintains the body's function, specifically for nerves and muscles. People generally intake sodium from the food they eat. Your kidneys are responsible for maintaining the sodium levels in your body. Potassium – It transfers signals from the nerve to the muscles. Potassium plays a vital role in the metabolism of cells. It also comes from the food you eat. Bicarbonate – It controls the pH level of your body and shows the amount of carbon dioxide in your blood. Chloride – It balances the acid-base level in the body. A chloride regulates the amount of fluid throughout the body. Protein tests Albumin – It is a protein in your blood made by your liver. It carries enzymes, nutrients, and other substances in your bloodstream. It also helps to resist fluid from leaking from the blood vessels. Total protein – This test measures other proteins (globulins) besides albumin. Kidney tests Two kidney tests, such as: Blood urea nitrogen (BUN) – This component specifies the quantities of urea nitrogen level in blood. Blood urea nitrogen is a waste material your kidneys remove from your blood. Creatinine – It is a waste product produced by creatinine. It develops during the regular activity of the muscles. A creatinine test indicates the function of the kidney. What is the purpose of the CMP test? Your provider may order a comprehensive metabolic panel test, a part of a routine blood test. This test provides complete information about the functions of the body and its working conditions. A CMP test determines following Acid-base balance in your body Electrolytes and fluid balance Blood sugar level Liver and kidney Blood protein level Metabolism When do I need a CMP test? A comprehensive metabolic panel test is a routine checkup for a person. It can help to screen and diagnose various diseases before or after they happen. If you have symptoms of liver, kidney, heart, or muscle problems, your doctor recommends this test. How to prepare for the test? You may need to keep fast for at least 8 to 10 hours and can only drink water during this time. Your healthcare provider may instruct you to follow specific instructions if needed. What happens during a comprehensive metabolic panel test? Your healthcare provider will ask you to provide a blood sample. A needle injects into a vein in your arm. A small amount of blood collects in a test tube. Your provider applies a bandage to your vein where the needle injects. CMP blood test does not take time greater than 5 minutes. What are the risks of the test? A CMP is a blood test that possesses a low risk. People can experience a slight pain or bruise at the position where the needle goes into their vein. These signs do not stay last for long. What does a CMP test result mean? The CMP is a combination of different tests. If one or more test results are unsatisfactory, it could be due to various diseases such as liver, kidney, diabetes, or heart disease. Your healthcare provider will recommend more tests to understand the specific conditions. Is there anything else I need to know about the CMP test? Your doctor may suggest this test by observing your symptoms and health conditions. You don't need always have a medical problem if one of your CMP test results is abnormal. Some factors may affect the test, such as the intake of certain medicines, diet, and health conditions. You can place an online order for a comprehensive metabolic panel test in less time. Visit UmbrellaMD to book your lab test and make an appointment with your doctor. Umbrella Health Care Systems is an online healthcare site that provides services, including laboratory tests, connections with doctors, pharmacies, and medical imaging. You can make an e-consultation by registering yourself here.
"Preferred Specimen(s) 2 mL serum Alternative Specimen(s) Spun Serum Separator Tube (SST®) Minimum Volume 1 mL Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 48 hours Refrigerated: 72 hours Frozen: 5 days Reject Criteria Moderate to gross hemolysis • Plasma Includes Albumin, Albumin/Globulin Ratio (calculated), Alkaline Phosphatase, AST, BUN/Creatinine Ratio (calculated), Calcium, Carbon Dioxide, Chloride, Creatinine with GFR Estimated, Globulin (calculated), Glucose, Potassium, Sodium, Total Bilirubin, Total Protein, Urea Nitrogen Patient Preparation Fasting specimen preferred Methodology See individual tests Reference Range(s) See Laboratory Report
COMPREHENSIVE METABOLIC PANEL, plasma Any other names for this test? This test is also known as chem 14, the chemistry panel, the chemistry screen, and the metabolic panel. What is a comprehensive metabolic panel, plasma test? This panel consists of a series of tests that provide details about a person's blood levels of electrolytes, calcium, phosphorus, and glucose, as well as about their kidney, hepatic, and acid-base functions. The panel is typically requested as part of a physical exam to look for a variety of illnesses, particularly ones that could impact the liver or kidneys. What tests are measured on a comprehensive metabolic panel, plasma test? A comprehensive metabolic panel, plasma test your blood for the following substances: Glucose: Glucose is a form of sugar that gives your body and brain energy. Blood sugar is another name for glucose. A high fasting blood glucose level is frequently an indication of type 2 diabetes. Fasting or not, extremely high glucose levels typically signal Type 1 diabetes. Calcium: Calcium is one of the most significant and common minerals in your body. You need calcium in your blood even though the majority of it is stored in your bones. The normal function of your heart, muscles, and neurological system depends on blood calcium. Total protein: This number represents the sum of the albumin and globulin proteins in your blood. Bilirubin: Bilirubin is a waste product formed when red blood cells break down. The purpose of the liver is to eliminate bilirubin from your body. BUN (blood urea nitrogen): Blood urea nitrogen, or BUN, is a urea nitrogen measurement. Your kidneys assist in removing this waste material from your blood. Creatinine: Creatinine is a byproduct of muscle activity. Your kidneys filter it and remove it as waste from your blood. Albumin: Albumin is a protein that is made from your liver. It transports essential nutrients throughout your bloodstream and stops fluid from flowing out of your blood vessels. A CMP also measures the four electrolytes listed below. They are referred to as electrolytes when minerals dissolve in a liquid and produce an electric charge. Your blood's electrolytes regulate nerve and muscle function as well as the pH and water balance in your body. Sodium: Your kidneys aid in maintaining healthy amounts of sodium in your body, which is primarily obtained from the foods you eat. Potassium: Potassium is a mineral derived from food and is present in all body tissues. Bicarbonate: The amount of bicarbonate in your blood indicates the presence of carbon dioxide (CO2). Chloride: Chloride regulates many body processes in conjunction with sodium, potassium, and bicarbonate. A CMP test is used to measure three more liver enzymes. Enzymes are chemicals that act as catalysts in specific physiological processes. Aspartate aminotransferase (AST). Alkaline phosphatase (ALP). Alanine transaminase (ALT) What is a comprehensive metabolic panel (CMP) test used for? Healthcare professionals frequently use a complete metabolic panel (CMP) test to diagnose your general physical health. With the help of its 14 test measurements, it can evaluate several bodily processes and functions, including: Your liver and kidneys work. Your blood sugar level. The acid and base levels in your blood are balanced. Your balance of electrolytes and water. Your healthcare physician may order a comprehensive metabolic panel, plasma test you for any of the following reasons, depending on the circumstances: Diagnosis: A CMP can help your doctor identify many diseases and conditions. Screening: The process of identifying health issues before they become symptoms is known as screening. Frequent screening helps identify several illnesses early. A CMP is frequently used via healthcare professionals as part of routine health screening because it includes 14 different measurements. Monitoring: If you have a particular medical condition, a CMP could help your doctor determine whether the medication is working as it should. CMPs can also be used to check for negative reactions to drugs, especially those that could affect your liver or kidneys. Why do I need a comprehensive metabolic panel, plasma test? A comprehensive metabolic panel, plasma test can be used in a variety of conditions, including: If you have symptoms of liver, kidney, or metabolic problems. If you have multiple symptoms, such as fatigue, because a CMP evaluates several vital blood components, it can assist in identifying or ruling out causes for common illnesses. Your doctor might want to retest you if you previously had an abnormal test result to determine whether your levels have changed or are still abnormal. If you are having treatment for a medical condition, your doctor may order tests to see whether the treatment is effective. If you are starting a new medication, that could affect how well your liver or kidneys work. If you suffer from any of the symptoms mentioned above, book a comprehensive metabolic panel (CMP) test for yourself. What happens during a comprehensive metabolic panel, plasma test? Your doctor will collect a small amount of blood from a vein in your arm with a tiny needle and place it in a test tube for further analysis. The needle's in-and-out movement may cause some discomfort. The test just lasts five minutes. Will I need to do anything to prepare for the test? It may be necessary for you to fast (without eating or drinking for at least eight hours) before taking the test. Are there any risks to the test? There is no harmful risk associated with a comprehensive metabolic panel, plasma test but the area where the needle went may cause you some discomfort. What do the results mean? Numerous disorders can be identified if any comprehensive metabolic panel, plasma test result or group of results is abnormal. Diabetes, kidney disease, and liver disease are some of them. Further tests will almost certainly be required to confirm or rule out a specific diagnosis. If you have any questions about your results, consult with your healthcare provider. Is there anything else I need to know about a comprehensive metabolic panel, plasma test? A basic metabolic panel test is equivalent to a CMP (BMP). A BMP is composed of the same eight tests as a CMP. It eliminates the liver and protein tests.
"Preferred Specimen(s) 2 mL serum Alternative Specimen(s) Spun Serum Separator Tube (SST®) Minimum Volume 1 mL Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 48 hours Refrigerated: 72 hours Frozen: 5 days Reject Criteria Gross hemolysis • Plasma Includes Albumin, Albumin/Globulin Ratio (calculated), Alkaline Phosphatase, AST, BUN/Creatinine Ratio (calculated), Calcium, Chloride, Creatinine with GFR Estimated, Globulin (calculated), Glucose, Potassium, Sodium, Total Bilirubin, Total Protein, Urea Nitrogen Patient Preparation Fasting specimen preferred Methodology See individual tests Reference Range(s) See Laboratory Report
Clinical Significance ABO Group and Rh Type, Cord Blood - ABO type and Rh are needed from cord blood to determine the newborn's blood type and Rh. Methodology Immune Agglutination Preferred Specimen(s) 5 mL cord blood collected in an ACD-A or ACD-B (yellow-top) tube Alternative Specimen(s) Red-top tube (no gel) • EDTA (pink-top) tube • EDTA (lavender-top) tube Note: If submitted with a CBC, HbA1c, or any other test requiring an EDTA (lavender-top) tube, please submit a separate tube for this test Minimum Volume 1 mL Collection Instructions Sample should be labeled with infant's name, sex and date of birth Transport Container ACD-A or ACD-B (yellow-top) tube Transport Temperature Room temperature Specimen Stability Room temperature: 72 hours Refrigerated: 7 days Frozen: Unacceptable Reject Criteria Hemolysis • Serum Separator Tube (SST®)
Clinical Significance Corn Smut, Tilletia tritici (m201), IgE - This allergen-specific IgE antibody test quantifies an individual’s IgE response to corn smut. It is an in vitro quantitative assay that is intended to be used in conjunction with other clinical information to aid in the diagnosis of allergic diseases [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. A definitive clinical diagnosis of allergy should not be based on the results of any single diagnostic method, but should be made by a trained healthcare provider after all clinical and laboratory findings have been evaluated. Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Methodology Immunoassay (IA) Assay Category This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. Alternative Name(s) ImmunoCAP®
Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Methodology Immunoassay - Analyte Specific Reagents Assay Category This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. Alternative Name(s) ImmunoCAP®
Clinical Significance Cow's Milk (f2) IgE - This test is an allergen-specific IgE antibody test that quantifies an individual’s IgE response to cow’s milk. It is an in vitro quantitative assay, which is intended to be used in conjunction with other clinical information to aid in the diagnosis of food allergy [1]. While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include 1) the presence of widespread skin disease, 2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, 3) uncooperative patients, and 4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1]. Food-specific IgE tests are extremely sensitive. However, a positive test result only indicates that a patient is IgE sensitized to the food of concern. Many IgE-sensitized patients do not develop any symptoms when this food is ingested. A diagnosis of food allergy should only be made by a trained medical provider, after conducting a thorough clinical evaluation [2,3]. While food-specific IgE test results may contribute to that evaluation, they cannot replace it. In this regard, detection of food-specific IgE in serum provides evidence of IgE sensitization, but a history of clinical reactivity to the food of concern, is required to make a diagnosis of IgE-mediated food allergy. Moreover, several forms of food hypersensitivity are not associated with the presence of food-specific IgE in serum. Preferred Specimen(s) 0.3 mL serum Minimum Volume 0.15 mL/allergen Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days
Creatinine Does this test have other names? Urine creatinine, blood creatinine, serum creatinine What is a creatinine test? A creatinine test determines the creatinine level in blood or urine. Creatinine is a waste product developed by your daily muscle activities. The kidney filters the creatinine from the blood and excretes it through the urine. The creatinine level shows the working condition of the kidney. The higher creatinine levels in your blood lead to renal or kidney disease. The reason for this is the decreased level of creatinine in the urine. A serum creatinine measures the quantity of creatinine in the blood. The urine creatinine test helps to indicate the total amount of creatinine present in the urine over 24 hours. What is the use of the serum creatinine test? This test examines and diagnoses the function of the kidneys. A serum creatinine test performs along with another kidney test called blood urea nitrogen (BUN). It is also a part of a comprehensive metabolic panel (CMP), a combination of tests that gives information about different organs of your body. A CMP is the most common test for a routine checkup. When do you need a creatinine test? The primary goal of this test is to monitor and screen for kidney problems. If you have symptoms of kidney disease, your doctor may recommend this test. Some of the signs include Cloudy or bloody urine Fatigue Urine incontinence Reduction in appetite Painful urine Swelling in the feet or ankles Puffiness near the eyes You may go for this test if you have symptoms of kidney disease. This include High blood pressure Diabetes type 1 or type 2 Kidney disease in family history How to prepare for a serum creatinine test? You may need to avoid cooked meat for 24 hours because it may increase creatinine levels. Certain medicines and supplements may have an impact on the creatinine level. You may ask for a prescription from your doctor to reduce the effect of the particular medication that you have used. You can get complete information from your nurse or a doctor for a 24-hour urine sample collection. Which sample is required for the test? A sample of blood or urine may be required for this test. Your lab care provider specifies the sample container. Creatinine blood test In this test, you need to provide a blood sample. Your healthcare will take a small amount of blood from your veins. This test is conducted within 5-10 minutes. Creatinine urine test You will collect all your urine produced over 24 hours in a sample container. Follow these steps for a 24-hour creatinine urine test Do empty your bladder first in the morning and flush it out. Besides, record the time Put all urine in a specimen for the upcoming 24-hours period. Save that sample of urine in a refrigerator or a cold place You can give the specimen sample to your healthcare provider. What are the recommended results for this test? Creatinine levels vary according to a person's size and muscle mass. According to the American Board of Internal Medicine, the value of test results for the creatinine blood test in men is 0.7 to 1.3 mg/dL (61.9 to 114.9 µmol/L). In women, it lies between 0.6 to 1.1 mg/dL (53 to 97.2 µmol/L. Women have lower creatinine levels as compared to men. It is because they frequently have low muscle mass. For 24-hour urine, the value ranges from 15 to 25 milligrams per kilogram of body weight (mg/kg). The normal range for a creatinine test may vary a little among different labs. Some labs use different measurements or test samples. You can discuss the results of your test with your doctor. What causes high creatinine in your blood? When the kidney does not adequately filter the blood, it may lead to a high level of creatinine in the blood. The creatinine level gives you the calculations of the estimated glomerular filtration rate, which helps in accessing the function of the kidneys. High levels of creatinine can occur due to many reasons, such as Blocked urinary tract Heart failure Complications of diabetes Kidney infection due to bacteria Autoimmune system disorder Dehydration in the body Muscular problems like rhabdomyolysis Complications of pregnancy An abnormality in the creatinine level may not always show a kidney disease. Here are a few more causes that lead to elevated levels of creatinine. A diet enriched with red meat Pregnancy Severe exercise Having a greater or less muscle mass, such as obese and malnourished people Certain medications Older people have low creatinine levels due to the reduction in their muscles Mass Is there any risk to this test? You may experience a little pain at the point of your vein where the needle inserts. This pain usually subsides in a short period. For the urine test, there is no risk to your health. Is there anything else I need to know about a creatinine test? Your doctor may recommend a creatinine clearance test to obtain accurate information about your kidneys. The creatinine clearance test is a ratio of the creatinine level in the blood to the creatinine level in the urine. If you experience the symptoms of an abnormal level of creatinine, you need to conduct this test. Visit UmbrellaMD to place the order for this test. You can also make an appointment with the doctor to understand your test results. Umbrella Health Care Systems is an online platform that makes your life simple and beneficial. You can also use the mobile app for e-consultation. It provides a better and more secure online connection with your doctor. It is the fastest place to schedule any online lab test by registering yourself.
Preferred Specimen(s) 0.3 mL serum Transport Container Serum Separator Tube (SST®) Transport Temperature Room temperature Specimen Stability Room temperature: 14 days Refrigerated: 14 days Frozen: 30 days Methodology Ion Selective Electrode (ISE) Reference Range(s) ≤1 Week 3.2-5.5 mmol/L 8-27 Days 3.4-6.0 mmol/L 1-5 Months 3.5-5.6 mmol/L 6 Months-1 Year 3.5-6.1 mmol/L 2-19 Years 3.8-5.1 mmol/L ≥20 years 3.5-5.3 mmol/L