Type |
Cause |
Underlying Abnormality |
Resulting Symptoms and Metabolic Abnormalities |
1 |
May be hereditary or may be triggered by an autoimmune disorder or certain drugs Cause usually not known, especially in women |
Inability to excrete acid into the urine |
High blood acidity Mild dehydration Low potassium levels in the blood, leading to muscle weakness and paralysis Fragile bones Bone pain Calcium deposits, leading to kidney stones |
2 |
Usually caused by a hereditary disease such as Fanconi syndrome, hereditary fructose intolerance, Wilson disease, or oculocerebrorenal syndrome (Lowe syndrome) May also be caused by multiple myeloma, heavy metal poisoning, or certain drugs |
Inability to reabsorb bicarbonate from the urine, so too much bicarbonate is excreted |
High blood acidity Fragile bones Bone pain Mild dehydration Low potassium levels in the blood Decreased production of the active form of vitamin D |
4 |
Not hereditary Caused by diabetes, an autoimmune disorder, chronic kidney disease, or an obstruction in the urinary tract Worsened by certain drugs, including potassium-sparing diuretics, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers |
Deficiency of or inability to respond to aldosterone, a hormone that helps regulate potassium and sodium excretion by the kidneys |
Mildly increased blood acidity and high potassium levels in the blood that rarely cause symptoms, unless the potassium level is unusually high (in that case, irregular heartbeats and muscle paralysis develop) |
Note: Type 3 is a mixture of Types 1 and 2 and is extremely rare. |