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Basic Metabolic Panel

What is a basic metabolic panel?

Whether you’re going to see your doctor for a routine checkup or you’re admitted to the hospital, your doctor needs information about how your body is functioning. A basic metabolic panel is a combination of tests that helps them assess important functions in your body.

The tests that make up the basic metabolic panel are blood (serum) tests for:

  • BUN (blood urea nitrogen), which measures the amount of nitrogen in the blood in order to determine your kidney function
  • creatinine, which can tell your doctor how your kidneys are functioning
  • glucose, which checks your blood sugar levels — abnormally high or low glucose levels could indicate a range of issues
  • albumin, which is a protein that can change with kidney and liver disease
  • CO2 (carbon dioxide or bicarbonate), which references lung and kidney function
  • calcium, which can help determine if there is a kidney bone or parathyroid problem (a gland in the neck)
  • sodium, one of the salts in the body that reflects more the body’s water balance than salt
  • potassium, another salt in the body
  • chloride

Your sodium, potassium, and chloride levels will be tested as part of your electrolyte panel. Electrolyte balance is essential to the normal functioning of the muscular, cardiovascular, and nervous systems.

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Purpose

Why is a basic metabolic panel performed?

The basic metabolic panel can give your doctor a good idea as to whether you have any serious problems with:

  • blood filtration
  • acid/base balance of your blood
  • blood sugar levels
  • electrolyte levels

This can help uncover a variety of medical issues, including:

  • kidney problems
  • lung problems
  • problems with your pancreas or insulin metabolism

More detailed tests will be ordered if any of these basic indicators are abnormal.

One advantage of a panel of tests is that many tests can be done with just one blood sample. It’s then divided up in a lab.

Procedure

How is a basic metabolic panel performed?

A small amount of your blood is needed to perform this panel of tests. The blood sample is obtained through “venipuncture.” A needle is inserted into a vein in your arm or hand. Blood is drawn through the needle into a tube and analyzed in a laboratory.

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Preparation

How do I prepare for a basic metabolic panel?

You do not need to do anything special before this test and should not stop taking medication unless your doctor tells you to.

Risks

What are the risks of a basic metabolic panel?

When the blood is collected, you may feel some moderate pain or a mild pinching sensation. After the needle is removed, you may feel a throbbing sensation. You’ll be instructed to apply pressure to the site where the needle entered your skin. A bandage will be applied and will need to remain in place for 10 to 20 minutes to stop any bleeding. You should avoid using that arm for heavy lifting for the rest of the day.

There are some very rare risks involved in taking a blood sample, including:

  • lightheadedness or fainting
  • hematoma, a bruise where blood accumulates under the skin
  • infection, which is usually prevented if the skin is cleaned before the needle is inserted
  • excessive bleeding for a long period after the test, which may indicate a more serious bleeding condition and should be reported to your doctor
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Normal results

Normal results for a basic metabolic panel

Normal ranges will vary slightly for adults over the age of 60 years.

Test Normal range (adults 18-60 years old) Normal range (adults over 60 years old) Category
BUN (blood urea nitrogen) 6-20 mg/dL (milligrams per deciliter of blood) 8-23 mg/dL kidney test
creatinine 0.9-1.3 mg/dL for men; 0.6-1.1 mg/dL for women 0.8-1.3 mg/dL for men; 0.6-1.2 mg/dL for women kidney test
glucose 70-99 mg/dL 70-99 mg/dL sugar metabolism
albumin 3.4-5.4 g/dL (grams per deciliter of blood) 3.4-5.4 g/dL blood protein
CO2 (carbon dioxide or bicarbonate) 23-29 mEq/L (milliequivalent units per liter of blood) 23-31 mEq/L (adults 61-90 years old); 20-29 mEq/L (adults over 90 years old) electrolyte panel
Ca+ (calcium) 8.6-10.2 mg/dL 8.6-10.2 mg/dL electrolyte panel
Na+ (sodium) 136-145 mEq/L 132-146 mEq/L (adults over 90 years old) electrolyte panel
K+ (potassium) 3.5-5.1 mEq/L 3.5-5.1 mEq/L electrolyte panel
Cl- (chloride) 98-107 mEq/L 98-111 mEq/L (adults over 90 years old) electrolyte panel
 
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Abnormal results

Abnormal results for a basic metabolic panel

Abnormal test results may indicate a serious medical condition, such as kidney disease, diabetes, or lung disease.

Kidney tests

A high BUN level may indicate kidney disease, such as glomerulonephritis or kidney failure. Other possible causes include congestive heart failure or hypovolemic shock. Steroids can increase your BUN, as can bleeding. A low BUN level may point to liver problems or insufficient protein in your diet.

A high creatinine level may also indicate kidney problems, muscle disease, or preeclampsia. A low creatinine level may be due to muscular dystrophy or myasthenia gravis, a rare disorder.

Learn more: Kidney health and kidney disease basics »

Sugar metabolism

Fasting blood glucose levels may help to diagnose diabetes. You may have diabetes if your fasting blood glucose is over 126 mg/dL. Other problems, such as hyperthyroidism and certain kinds of pancreatic cancers, involve high blood glucose. Low blood glucose may indicate an underactive pituitary or thyroid or adrenal gland. Low glucose can also occur when a person with diabetes consumes too much insulin or other diabetic medications, or eats too little food while taking these medications.

Learn more: Understanding borderline diabetes: Signs, symptoms, and more »

Blood protein

High levels of albumin are very rare. Low albumin levels may be due to kidney or liver disease, recent weight loss surgery, or a low protein diet.

Electrolyte panel

High bicarbonate or carbon dioxide levels may be caused by breathing problems, metabolic problems, Cushing’s syndrome, or hormonal problems. Lower-than-normal levels can be caused by acidosis, kidney disease, or several kinds of poison toxicities.

Read more: Cushing’s syndrome »

High serum calcium can be caused by problems with the parathyroid gland most commonly, or certain types of cancer. Low serum calcium levels can be caused by many conditions, including:

  • an inactive parathyroid gland
  • kidney or liver failure
  • vitamin D deficiency
  • problems with your pancreas

High serum sodium may be due to various hormonal diseases, such as diabetes insipidus or Cushing’s syndrome. A lower-than-normal sodium level may also be due to hormonal abnormalities, such as Addison’s disease or SIADH (syndrome of inappropriate hormone secretion). Low sodium may also be due to dehydration, vomiting, and heart, liver, or kidney failure.

Read more: Addison's disease »

High serum potassium is often an indication of kidney disease. Potassium is very important for muscle function. High potassium levels can cause problems with the electrical activity of the heart. Low serum potassium may be due to the use of diuretic medications or certain hormonal problems. Low levels can cause an irregular heartbeat.

High chloride levels may indicate metabolic acidosis, where the kidneys are not removing enough acid from the body. Low chloride levels may be due to Addison’s disease, congestive heart failure, or dehydration. Metabolic alkalosis and a number of other abnormalities affect chloride levels as well.

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Following up

Following up

These are all brief summaries of possible causes for abnormal test results. Talk to your doctor about each specific test in detail to learn more about what abnormal levels may indicate.

Q&A

Q&A

  • What are the differences between the basic metabolic panel and the comprehensive metabolic panel?
  • The only difference between a basic and a comprehensive metabolic panel is the addition of a liver panel for the comprehensive panel. The liver panel includes total protein, aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, alkaline phosphatase (Alk Phos), and bilirubin. The total protein is used in comparison to the albumin. If it is much higher than expected, this can indicate inflammation, liver disease, or multiple myeloma. AST and ALT are two enzymes that are mostly made in the liver, and high levels can mean there has been damage to the liver from anything from alcohol to viruses. Low levels may be normal or mean that the liver is not working well enough to produce enough. Bilirubin comes in two forms and depending upon which part is high, can mean a problem with the gallbladder or else destruction of blood cells. Alk Phos can be high in gallbladder disease or bone disease

    - University of Illinois-Chicago, College of Medicine
  • Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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