-The present study explores whether the development of hypertension in the Milan strain of rats (MHS) rats is preceded or paralleled by alterations of mRNA and/or protein levels of the major luminal Na ϩ transporters. MHS rats were studied at 23-25 days after birth; age-matched Milan normotensive (MNS) rats were used as controls. The glomerular filtration rate (GFR), measured by inulin clearance, was higher in MHS than in MNS rats, while the mean blood pressure was not different in the two strains of animals indicating that the MHS rats were still in the prehypertensive state. Type 3 sodium/hydrogen exchanger (NHE3), bumetanide-sensitive sodium-potassium-2 chloride cotransporter (NKCC2), sodium-chloride cotransporter (NCC) and ␣-ENaC mRNA abundances were quantified by competitive PCR. In MHS compared with MNS, mRNA abundance was unchanged for NHE3 in proximal tubules, higher for NKCC2 in medullary thick ascending limbs of Henle's loops (TAL) and lower for NCC in distal convoluted tubules (DCT) and for ␣-ENaC along collecting ducts (CD). Western blot experiments revealed 1) unchanged NHE3; 2) a significant increase in NKCC2 in the outer medulla; 3) a significant decrease in NCC in the renal cortex and of ␣-ENaC in both the renal cortex and outer medulla, whereas -and ␥-ENaC remained unchanged. These data indicate that, in MHS rats, there is a strong upregulation of NKCC2 along the TAL associated with increased GFR, robust inhibition of NCC cotransporter along the DCT and modest downregulation of ␣-ENaC along the CD. The interplay of the various Na ϩ transporters may well explain why, at this age, the rats are still in the prehypertensive state.type 3 sodium/hydrogen exchanger; sodium-potassium-2chloride cotransporter; sodium-chloride cotransporter; epithelial sodium channel; sodium; kidney HYPERTENSION IS A MAJOR RISK factor for heart disease, stroke, and renal failure. Although its pathogenesis is unknown in the majority of patients, it is becoming evident that the kidney may play an important role in both the induction and maintenance of many types of systemic hypertension. Accordingly, hypertension accompanies the kidney when this organ is transplanted from a genetically hypertensive into a normal rat (5). In addition, recent human genetic studies demonstrate that mutations of genes, encoding for proteins expressed in the kidney and involved in tubular ion transport, are associated with modifications of systemic blood pressure. For instance, lossof-function mutations of transport molecules in the thick ascending limb of Henle's loop (TAL) lead to Bartter's syndrome, and a defective thiazide-sensitive sodium-chloride cotransporter (NCC), present in the distal tubule, is the cause of Gitelman's syndrome (40). The modifications of these iontransporting systems are characterized by urinary sodium loss, resulting in orthostatic hypotension. In contrast, gain-of-function mutations of amiloride-sensitive sodium channels in the collecting ducts generate Liddle's syndrome, which is phenotypically characterized by syst...