Blood chemistry tests

What happens if a change or abnormality is found

Blood chemistry tests or panels are groups of tests that measure many chemical substances in the blood that are released from body tissues or are produced during the breakdown (metabolism) of certain substances. These tests are performed on a blood sample.

There are many different types of blood chemistry tests.

Blood chemistry test	Substances measured
electrolyte panel	sodium potassium chloride bicarbonate
kidney function tests	blood urea nitrogen (BUN) creatinine
liver function tests	alanine aminotransferase (ALT) alkaline phosphatase (ALP) aspartate transaminase (AST) bilirubin albumin total protein
basic metabolic panel (BMP)	glucose calcium electrolyte panel kidney function
comprehensive metabolic panel (CMP)	glucose calcium electrolyte panel kidney function liver function

Why a blood chemistry test is done

A blood chemistry test may be done to:

evaluate a person’s general health status
evaluate organ function
evaluate the body’s electrolyte balance
identify potential organ damage or injury
identify damaged tissues that secrete chemicals into the blood

How a blood chemistry test is done

A blood chemistry test is usually done in a private laboratory or hospital laboratory. Preparation depends on the type of test being done.

Fasting overnight may be required, especially if certain chemicals (such as glucose or lipid levels) are being tested.
Blood is usually taken from a vein in the arm.
A tourniquet or elastic band is wrapped around the upper arm to apply pressure to the area and make the vein swell.
The person may be asked to open and close the fist to make the veins stand out more.
The skin is cleaned and disinfected.
A needle is inserted into the vein and a small amount of blood is removed.
- The person will feel a prick or stinging sensation.
The sample is collected in a tube and labelled with the person’s name and other identifying information.
The tourniquet is removed and the needle is withdrawn.
- Mild discomfort may be felt when the needle is withdrawn.
Pressure is applied to the area where the needle was inserted until bleeding stops.
A band aid may be applied.
For some tests, the blood sample is allowed to clot and the clear yellow fluid (serum) that forms above the clot is carefully separated and removed for analysis.
The sample is sent to a laboratory to be analyzed by special machines, examined under a microscope or both.

Potential side effects

Potential side effects of having a blood chemistry test include:

bleeding
bruising
infection

What the results mean

Normal ranges may vary from person to person and laboratory to laboratory. Many factors can affect blood chemistry results. Values may be abnormal for reasons other than cancer.

Increased blood chemistry values

Component	An increased value may be due to	A decreased value may be due to
ALP	primary bone cancer or cancer that has spread to the bone (bone metastasis) primary liver cancer or cancer that has spread to the liver (liver metastasis) lung cancer pancreatic cancer
ALT and AST	liver disease liver cancer cancer that has spread to the liver (liver metastasis)
albumin		inflammation or infection liver disease kidney disease
bilirubin	liver disease or blockage (obstruction) within the liver due to tumours blockage of the bile duct (obstruction) by a tumour cancer in the head of the pancreas
BUN	kidney disease or blockage (obstruction) of the urinary tract by a tumour	liver disease
calcium	parathyroid gland tumours that produce parathyroid hormone tumours that produce parathyroid hormone-like substances or cause bone destruction, such as cancer that has spread to the bone (bone metastasis) lymphoma leukemia multiple myeloma some types of head and neck cancer	pancreatic disease kidney failure
creatinine	kidney disease or blockage (obstruction) of the urinary tract by a tumour cancer can cause the body to use and breakdown more protein	liver disease
glucose	conditions such as diabetes inflammation of the pancreas liver disease	pancreatic tumours
lactate dehydrogenase (LDH)	many diseases, including liver disease many cancers, including advanced cancers leukemia lymphoma
phosphorus (phosphate)	kidney disease liver disease tumour lysis syndrome primary bone cancer or cancer that has spread to the bone (bone metastasis)	liver disease
uric acid	leukemia multiple myeloma lymphoma excess cell destruction that may follow chemotherapy and radiation therapy (tumour lysis syndrome)	Hodgkin lymphoma multiple myeloma

Note: Not all factors or conditions that can increase blood chemistry components are listed above. Only the main cancer-related ones have been included.

What happens if a change or abnormality is found

The doctor will decide if more tests, procedures, follow-up care or treatment are needed.

References

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