The role of the lysosomal proteases cathepsins B and L and the calcium-dependent cytosolic protease calpain in hypoxia-induced renal proximal tubular injury was investigated. As compared to normoxic tubules, cathepsin B and L activity, evaluated by the specific fluorescent substrate benzyloxycarbonyl-L-phenylalanyl-L-arginine-7-amido-4-methylcoumarin, was not increased in hypoxic tubules or the medium used for incubation of hypoxic tubules in spite of high lactate dehydrogenase (LDH) release into the medium during hypoxia. These data in rat proximal tubules suggest that cathepsins are not released from lysosomes and do not gain access to the medium during hypoxia. An assay for calpain activity in isolated proximal tubules using the fluorescent substrate N-succinyl-Leu-Tyr-7-amido-4-methylcoumarin was developed. The calcium ionophore ionomycin induced a dose-dependent increase in calpain activity. This increase in calpain activity occurred prior to cell membrane damage as assessed by LDH release. Tubular calpain activity increased signifi'cantly by 7.5 min of hypoxia, before there was significant LDH release, and further increased during 20 min of hypoxia. The cysteine protease inhibitor N-benzyloxycarbonyl-Val-Phe methyl ester (CBZ) markedly decreased LDH release after 20 min of hypoxia and completely prevented the increase in calpain activity during hypoxia. The increase in calpain activity during hypoxia and the inhibitor studies with CBZ therefore supported a role for calpain as a mediator of hypoxia-induced proximal tubular injury.The mechanisms responsible for hypoxia-induced tubular epithelial cell injury and death are controversial (1). Intracellular calcium has been suggested to be important in mediation of this hypoxic injury in renal proximal tubules (2). Our laboratory recently reported that cytosolic free Ca2+ [(Ca2+)i] is significantly increased by 2 min of hypoxia in proximal tubules, and that (Ca2+)i levels at 10 min of hypoxia correlated with subsequent damage at 20 min (3). Thus, prompt increases in (Ca2+), may play an initiating role in hypoxic injury. This conclusion was supported by the protection afforded by prevention of the increase in (Ca2+), (3,4). The mechanisms whereby increases in (Ca2+), lead to cell membrane injury, however, remain to be defined. An increase in (Ca2+)i may activate calcium-dependent enzymes, which could provide a mechanism for cell injury. The increase in (Ca2+)i during hypoxia may activate phospholipase A2 and thus be partly responsible for phospholipid degradation in membranes observed during hypoxia (5). Another potential mechanism for calcium-dependent cell injury is activation of the calciumdependent cytosolic protease calpain. In certain circumstances, proteases have been shown to play a role in cellular injury. For example, studies with cultured fibroblasts and the specific lysosomotropic detergent C12-imidazole demonstrated that cell killing can be caused by activation and/or release into the cytoplasm of cysteine proteases (6). Studies of cysteine p...