Metabolic Acidosis with Anion Gap - KILU Mnemonic



K - Ketoacidosis

	• DKA

		- With normal glucose, ask if on SGLT2 inhibitor.

		- Eugylcyemic ketoacidosis in SGLT2 inhibitors and SGLT2 deficiency mutation

	• Alcohol ketoacidosis - 10% have -ve urine ketones (their ketone is B-hydroxy butyrate)

	• Starvation



I - Ingestions 

	• ethylene glycol, methanol (for those, check osm gap, & alcohol level)

	• salicylates (+ resp alkalosis}, APAP (rare in lit), iron (pediatric), paraldehyde



L - Lactate 

	• Type A = tissue hypoxia (e.g. shock, dying gut/limb). 

	• Type B = lymphoma or leukemia or drug that results in lactate build-up, Beri-Beri, NRTl's, linezolid



U - Uremia

	• The anion is phosphate typically.



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