vation of purinergic receptors (P2) in the renal medulla promotes endothelin-dependent natriuresis in male rats. Am J Physiol Renal Physiol 311: F260 -F267, 2016. First published May 25, 2016 doi:10.1152/ajprenal.00090.2016.-Renal endothelin-1 (ET-1) and purinergic signaling systems regulate Na ϩ reabsorption in the renal medulla. A link between the renal ET-1 and purinergic systems was demonstrated in vitro, however, the in vivo interaction between these systems has not been defined. To test whether renal medullary activation of purinergic (P2) receptors promotes ET-dependent natriuresis, we determined the effect of increased medullary NaCl loading on Na ϩ excretion and inner medullary ET-1 mRNA expression in anesthetized adult male Sprague-Dawley rats in the presence and absence of purinergic receptor antagonism. Isosmotic saline (NaCl; 284 mosmol/kgH2O) was infused into the medullary interstitium (500 l/h) during a 30-min baseline urine collection period, followed by isosmotic or hyperosmotic saline (1,800 mosmol/kgH2O) for two further 30-min urine collection periods. Na ϩ excretion was significantly increased during intramedullary infusion of hyperosmotic saline. Compared with isosmotic saline, hyperosmotic saline infused into the renal medulla caused significant increases in inner medullary ET-1 mRNA expression. Renal intramedullary infusion of the P2 receptor antagonist suramin inhibited the increase in Na ϩ excretion and inner medullary ET-1 mRNA expression induced by NaCl loading in the renal medulla. Activation of medullary P2Y2/4 receptors by infusion of UTP increased urinary Na ϩ excretion. Combined ETA and ETB receptor blockade abolished the natriuretic response to intramedullary infusion of UTP. These data demonstrate that activation of medullary P2 receptors promotes ET-dependent natriuresis in male rats, suggesting that the renal ET-1 and purinergic signaling systems interact to efficiently facilitate excretion of a NaCl load.endothelin-1; purinergic receptors; natriuresis; kidney; inner medulla ENDOTHELIN-1 (ET-1) is an autocrine inhibitor of Na ϩ and water reabsorption by the kidney and plays a central role for the regulation of Na ϩ homeostasis and blood pressure control. Within the renal medulla, ET-1 is released in response to a high-salt diet and inhibits tubular Na ϩ transport promoting natriuresis (14, 17). It appears that both ET A and ET B receptors are required for the full diuretic and natriuretic effects of ET-1 (7). However, the signaling mechanism by which NaCl loading to the renal medulla translates into an increase in ET-1 production and/or action is currently unknown.Purinergic signaling has also emerged as another important system in the renal control of blood pressure and Na ϩ excretion (19,31). In response to increased tubular flow, ATP is released from renal tubular cells inhibiting Na ϩ transport along the nephron (12, 19), mainly through P2Y 2 receptor activation (18, 23). Both P2Y 2 knockout mice and ET B -deficient rats develop salt-sensitive hypertension (23, 30), suppo...