UMEM Educational Pearls

Category: Critical Care

Title: Anion Gap Acidosis is a "KILR"

Keywords: Anion gap, acidosis, metabolic acidosis, ingestion, critical care (PubMed Search)

Posted: 8/4/2015 by Daniel Haase, MD
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Ever forget all the things that make up MUDPILES in your AG acidosis differential?

Instead, consider the less-complicated mnemonic "KILR"!

K Ketoacidosis (diabetic, alcoholic, starvation)

I Ingestion (salicylate, acetaminophen, methanol, ethylene glycol, CO, CN, iron, INH)

L Lactic acidosis (infection, hemorrhage, hypoperfusion, alcohol, metformin)

R Renal (uremia)

Once you rule out the KLR causes, begin to consider ingestion or a tox source as your source. Remember that many of the listed ingestions can also cause a lactic acidosis.

References

For more acid/base pearls in greater detail:

http://lifeinthefastlane.com/ccc/anion-gap/

http://emcrit.org/wp-content/uploads/acid_base_sheet_2-2011.pdf (from emcrit.org)