Whether the tight junction is permeable to water remains highly controversial. Here, we provide evidence that the tricellular tight junction is important for paracellular water permeation and that Iglike domain containing receptor 1 (ILDR1) regulates its permeability. In the mouse kidney, ILDR1 is localized to tricellular tight junctions of the distal tubules. Genetic knockout of Ildr1 in the mouse kidney causes polyuria and polydipsia due to renal concentrating defects. Microperfusion of live renal distal tubules reveals that they are impermeable to water in normal animals but become highly permeable to water in Ildr1 knockout animals whereas paracellular ionic permeabilities in the Ildr1 knockout mouse renal tubules are not affected. Vasopressin cannot correct paracellular water loss in Ildr1 knockout animals despite normal effects on the transcellular aquaporin-2-dependent pathway. In cultured renal epithelial cells normally lacking the expression of Ildr1, overexpression of Ildr1 significantly reduces the paracellular water permeability. Together, our study provides a mechanism of how cells transport water and shows how such a mechanism may be exploited as a therapeutic approach to maintain water homeostasis.T ight junctions (TJs) are known to be leaky to ions and, thus, to constitute a paracellular pathway with ionic permselectivity similar to that of transmembrane channels (1). Whether the TJ is permeable to water, on the other hand, has been highly controversial. Jorge Fischbarg noticed that the corneal endothelium retained over 60% of water permeability even when AQP1, the only aquaporin expressed by these cells, was knocked out by genetic deletion (2). Rosenthal et al. have demonstrated that, in cultured renal epithelium expressing the claudin-2 protein, transepithelial water permeability was significantly higher than in cells without its expression (3). Using an optical microscopic approach, Spring and coworkers have directly measured the velocity of water flow across the tight junction and have ruled out the existence of any significant transjunctional water flow, at least for the bicellular TJ (bTJ) (4). The tricellular tight junction (tTJ) is a specialized cell junction different in ultrastructure from that of the bTJ (5). Unlike the bTJ, which is made of claudin and occludin (6), the proteins making the tTJ include tricellulin and angulins (LSR/angulin-1, ILDR1/angulin-2, and ILDR2/angulin-3) (7,8). Transgenic knockout (KO) of either tricellulin or Ildr1 in mice causes hearing loss due to degeneration of mechanosensory cochlear hair cells in the organ of Corti (9, 10). Peculiarly, neither the endocochlear potential nor the paracellular permeability in the stria vascularis changed in these mutant animals. The permeation property of tTJ therefore remains a major mystery.There are two forms of diabetes insipidus (DI): central (neurogenic) and nephrogenic. The nephrogenic DI (NDI) is caused by the inability of the kidney to reabsorb water. NDI is hereditary and has been linked to two genetic loci. The ...