There are three types of renal tubular acidosis. They include:

• Distal renal tubular acidosis (type 1) may be a hereditary condition or may be triggered by an autoimmune disease, lithium therapy, kidney transplantation, or chronic obstruction.
• Proximal renal tubular acidosis (type 2) is caused by hereditary diseases, such as Fanconi's syndrome, fructose intolerance, and Lowe's syndrome. It can also develop with vitamin D deficiency, kidney transplantation, heavy metal poisoning, and treatment with certain drugs.
• Type 4 renal tubular acidosis is not hereditary, but is associated with diabetes mellitus, sickle cell anemia, an autoimmune disease, or an obstructed urinary tract.

Symptoms vary with the underlying mechanism of the defect and the readjustment of chemicals required to compensate for the defect.

• Distal RTA results in high blood acidity and low blood potassium levels. Symptoms include mild dehydration; muscle weakness or paralysis (due to potassium deficiency); kidney stones (due to excess calcium in the urine); and bone fragility and pain.
• Proximal RTA also results in high blood acidity and low blood potassium levels. Symptoms include mild dehydration.
• Type 4 RTA is characterized by high blood acidity and high blood potassium levels; it rarely causes symptoms unless potassium levels rise so high as to cause heart arrhythmias or muscle paralysis.