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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