LABS

CHEMISTRY PANEL/BASIC METABOLIC PROFILE

Na+

Cl-

BUN
Glu

HCO3

Creat

GLUCOSE (Glu)
Normal Range = 60-110 mg/dL
Glucose is closely regulated so as to provide energy to all cells in the body
without allowing any spillover into the urine. The excess of glucose seen in
DM is the underlying cause for all complications of that disease.
Increased in: DM, cushings syndrome, chronic pancreatitis, corticosteroids,
phenytoin, estrogens, thiazides.
Decreased in: Insulinoma, adrenocortical insufficiency, hypopituitarism, liver
disease, malignancy, insulin, ethanol, propanolol, solfonylureas, tolbutamide.

BMP
SODIUM (Na+)
Normal Range = 135-145 mEq/L
Sodium is the predominant extracellular cation. Levels of sodium generally
reflect the hydration state of the patient.
Increased in: Dehydration, polyuria, hyperaldosteronism, steroids, oral
contraceptives, inadequate water intake.
Decreased in: CHF, vomiting, diarrhea, sweating, nephropathy, adrenal
insufficiency, thiazides, diuretics, ACE inhibitors, antidepressants,
antipsychotics.

CALCIUM (Ca2+)
Normal Range = 8.5-10.5 mg/dL
Calcium is important in bone mineralization as well as a clotting cofactor. It
is regulated by calcitonin and parathyroid hormone, and binds to albumin in
serum.
Increased in: Hyperparathyroidism, vitamin D excess, multiple myeloma,
pagets disease, sarcoidosis, vitamin A intoxification, addisons disease,
antacids, thiazides, lithium
Decreased in: Hypoparathyroidism, vitamin D deficiency, renal insufficiency,
magnesium/phosphorus deficiency, massive transfusion, hypoalbuminemia.

POTASSIUM (K+)
Normal Range = 3.5-5.0 mEq/L
Potassium is the primary intracellular cation and is the electrical balance to
sodium. Potassium imbalance causes disruption in the function of neurons
and muscles, and the symptoms of DKA are a result of the hypokalemia it
produces. Potassium movement also accompanies glucose, and in the kidneys
potassium is excreted at the expense of sodium. Potassium levels in the blood
are affected chiefly by pH; acidosis is accompanied by hyperkalemia, and
alkalosis causes hypokalemia. The action of catecholamines on beta receptors
has a secondary effect of reducing blood potassium.
Increased in: Hemolysis, tissue damage, acidosis, renal failure, addisons
disease, exercise, potassium-sparing diuretics, NSAIDs, -blockers, ACE
inhibitors, and TMX.
Decreased in: Prolonged vomiting/diarrhea, hyperaldosteronism, cushings
syndrome, osmotic diuresis, trauma, subarachnoid hemorrhage, adrenergic
drugs, diuretics.

ANION GAP
Normal Range = (Na+K) - (Cl+HCO3)<16, or Na - (Cl+HCO3)<12
Anion gap is an equation used to measure metabolic acidosis. Anions and
cations in the body sum to zero; anion gap is a measure of the sum of all
minor anions in the body. Increased anion gap indicates acidosis, whose
etiology is characterized by the acronym SLUMPED; Salicylates, Lactic acid,
Uremia, Methanol, Paraldehyde, Ethanol, and Diabetic ketoacidosis.

CHLORIDE (Cl-)
Normal Range = 98-107 mEq/L
Chloride is a secondary player in the maintenance of acid/base balance and is
a placeholder in the anion gap. Retention causes acidosis, loss alkalosis.
Increased in: Massive diarrhea, nephrotic syndrome, renal failure, diabetes
insipidus, hyperparathyroidism, acetazolamide, androgens, salicylates.
Decreased in: Vomiting, diarrhea, GI suction, DKA, respiratory acidosis,
excessive sweating, acute intermittent porphyria, adrenal insufficiency,
laxative use, corticosteroids, diuretics.
BICARBONATE (HCO3-)
Normal Range = 22-28 mEq/L
Bicarbonate is the main component of the bodys buffer system and is the
central player in regulation of blood pH. Bicarbonate levels are regulated by
the kidneys.
Increased in: metabolic alkalosis, compensated respiratory acidosis, volume
contraction, mineralocorticoid excess, diuretics.
Decreased in: Metabolic acidosis, compensated respiratory alkalosis,
fanconis synd, volume overload, acetazolamide.
BLOOD UREA NITROGEN (BUN)
Normal Range = 8-20 mg/dL
BUN is the end product of protein metabolism, and is directly related to the
amount of protein ingested. It is a relative indicator of kidney function.
Increased in: Renal failure, urinary tract obstruction, degydration, shock,
burns, CHF, GI bleed, nephrotoxic drugs.
Decreased in: Hepatic failure, nephritic syndrome, cachexia.
CREATININE (Creat)
Normal Range = 0.6-1.2 mg/dL
Creatinine is a normal product of the breakdown of muscle tissue, and is
produced at a constant rate. As such, it is an absolute indicator of kidney
function, and the ratio of BUN to Creat in the blood can give clues to the
etiology of a kidney problem. Increase in BUN and Creat is termed azotemia.
10:1 ratio is pre-renal azotemia, caused by insufficient renal blood flow. A
less than 10:1 ratio is renal azotemia, which is indicative of renal failure.
Increased in: Renal failure, urinary tract obstruction, nephrotoxic drugs,
hypothyroidism.
Decreased in: Reduced muscle mass.

PHOSPHORUS (P+)
Normal Range = 2.5-4.5 mg/dL
Phosphorus is the other mineral component to bone, and its levels in the blood
are regulated chiefly by the parathyroid gland and vitamin D.
Increased in: Renal failure, massive blood transfusion, hypoparathyroidism,
sarcoidosis, neoplasms, adrenal insufficiency, acromegaly, hypervitaminosis
D, leukemia, DKA, cirrhosis, respiratory acidosis, anabolic steroids,
furosemide, clonidine, verapamil, HCTZ.
Decreased in: Hyperparathyroidism, hypovitaminosis D, steatorrhea,
malnutrition, bone marrow transplantation, alcoholism, diarrhea, vomiting,
gout, osteoblastic disorders, respiratory alkalosis, pregnancy, hypothyroidism,
dialysis, anticonvulsants, -agonists, catecholamines, estrogens, insulin, ASA.
ALBUMIN
Normal Range = 3.4-4.7 g/dL
Albumin is the principal carrier protein in the blood and is a measure of
nutrition. Many hormones depend on albumin for transport in the blood.
Increased in: Dehydration, shock.
Decreased in: Liver disease, malnutrition, malabsorbtion, malignancy,
nephrotic syndrome, hemorrhage, fistulas, estrogens.
BILIRUBIN (Bili)
Normal Range = 0.1-0.4 (direct), 0.2-0.7 (indirect) mg/dL
Bilirubin is the product of heme metabolism, and is conjugated (direct bili) in
the liver for biliary excretion. Direct vs. indirect values predict etiology.
Increased in: Hemolysis (indirect), liver failure (indirect), hemorrhage
(indirect), biliary obstruction (direct), cirrhosis/hepatitis (both), CHF (both)
ALKALINE PHOSPHATASE (Alk Phos)
Normal Range = 41-133 IU/L
Alk phos is produced by osteoblasts and is an indication of skeletal turnover.
Increased in: Biliary obstruction, pagets disease, bone tumor,
hyperparathyroidism, rickets, pregnancy, GI disease, hepatotoxic drugs.
TOTAL PROTEIN
Normal Range = 6.0-8.0 g/dL
A group that includes albumin, total protein is an indicator of nutrition and is
the principal determinant in blood oncotic pressure.
Increased in: Gammopathies, dehydration, anabolic steroids, corticosteroids,
epinephrine, androgens.
Decreased in: Burns, nephrotic syndrome, malnutrition, chronic liver disease.
ALANINE AMINOTRANSFERASE (ALT, SGPT) Normal Range = 0-40 U/L
ASPARTATE AMINOTRANSFERASE (AST, SGOT) Normal Range = 0-35 U/L
These liver function enzymes are an indicator of liver damage or pathology.
Increased in: Hepatitis, cirrhosis, liver abscess, biliary obstruction, right-sided
heart failure, ischemia/hypoxia, abdominal trauma, hepatotoxic drugs.
Decreased in: Vitamin B6 deficiency