cies in the conversion between active and inactive glucocorticoids in the kidney can lead to hypertension. However, the significance of glucocorticoid metabolism in specific kidney regions in vivo is not clear, possibly in part due to the difficulty in measuring glucocorticoid levels in kidney regions in vivo. We used microdialysis techniques to sample renal interstitial fluid from conscious rats. The levels of corticosterone (active) and 11-dehydrocorticosterone (inactive) were analyzed by liquid chromatography-tandem mass spectrometry. Direct infusion of the 11-hydroxysteroid dehydrogenase (11-HSD) inhibitor carbenoxolone into the renal medulla induced hypertension, and significantly increased corticosterone levels and the corticosterone/ 11-dehydrocorticosterone ratio, an index of 11-HSD activity, in the renal medullary microdialysate, but not in urine or the plasma. Further characterization of conscious, untreated rats (n ϭ 13-16) indicated that corticosterone concentrations (ng/ml) were 0.8 Ϯ 0.1, 1.0 Ϯ 0.1, 66.7 Ϯ 8.1, and 7.9 Ϯ 1.1 in cortical microdialysate, medullary microdialysate, the plasma, and urine, respectively. The corticosterone/11-dehydrocorticosterone ratios were 0.8 Ϯ 0.1, 0.6 Ϯ 0.1, 10.6 Ϯ 1.4, and 1.7 Ϯ 0.1, respectively, in these 4 types of sample. The expression level of 11-HSD1 was higher in the medulla than in the cortex, whereas 11-HSD2 was most enriched in the outer medulla. Microdialysate levels of corticosterone were ϳ1.6-fold higher in afternoons than in mornings, whereas plasma levels differed by 2.8-fold. These results demonstrated that corticosterone excess in the renal medulla might be sufficient to cause hypertension and provided the first characterization of renal interstitial glucocorticoids.hypertension; 11-hydroxysteroid dehydrogenase; microdialysis; mass spectrometry THE BIOLOGICAL ACTIVITY OF glucocorticoids in target organ systems is controlled not only by circulating levels of glucocorticoids but also by intracellular metabolism in target tissue. The metabolism of glucocorticoids in target tissue involves several enzymatic reactions including the interconversion between active and inactive glucocorticoids catalyzed by 11-hydroxysteroid dehydrogenases (11-HSD) (7, 41). The type 2 isoform of the enzyme, 11-HSD2, converts active glucocorticoids, mainly cortisol in human and corticosterone in rodents, to inactive forms, cortisone in human and 11-dehydrocorticosterone in rodents. The type 1 isoform of the enzyme, 11-HSD1, has both dehydrogenase and reductase activities but may act predominantly as a reductase in vivo, regenerating biologically active glucocorticoids from their inactive forms (40).Local metabolism of glucocorticoids has particular relevance to renal function. Aldosterone is a powerful and important regulator of electrolyte transport in the distal nephron. Mineralocorticoid receptors in the distal nephron, however, can bind aldosterone and glucocorticoids with nearly equal affinity. 11-HSD2 in the distal nephron inactivates glucocorticoids and all...