Stover et al. (2002) identified a 41-year-old female patient with recessive distal renal tubular acidosis with progressive nerve deafness. The patient originated from a consanguineous family from Morocco.

Zakzouk et al. (1995) reported a follow-up of seven patients with autosomal recessive distal renal tubular acidosis and sensorineural hearing loss. Five patients were diagnosed as having primary distal renal tubular acidosis and rickets, four were found to have severe sensorineural hearing loss of over 80 dB: two of which are brothers. Two patients were diagnosed as having secondary distal renal acidosis due to a genetic disorder called osteopetrosis; they are brothers and their audiograms showed a mild conductive hearing loss of an average 35 dB bilaterally. All patients had growth retardation with improvement due to alkaline therapy but their hearing loss was not affected by the medication. The pedigrees of two families with half sibs showed the familial incidence for consanguineous marriage. Consanguinity was found to be positive in five out of the seven patients.

Al-Rasheed et al. (1998) observed, over a 10-year period, 28 Arab children with autosomal recessive osteopetrosis in two hospitals in Riyadh. Eighteen (64%) had osteopetrosis associated with metabolic acidosis probably due to a renal tubular defect; nine (32%) had a malignant infantile form of osteopetrosis and one had a mild form with delayed onset. Parental consanguinity was 56% and 40% among patients with and without acidosis respectively. Dental caries, cerebral calcification and optic atrophy were more frequent in patients with acidosis, while anemia, hepatosplenomegaly and deafness were more common in patients without acidosis.

Stover et al. (2002) identified four patients from Saudi Arabia with recessive distal renal tubular acidosis with progressive nerve deafness. The age of the patients ranged between 10-15 years and all were the results of consanguineous marriages.