This study is concerned with the relationship between the Na/K/CI cotransport system and the steady-state volume (MCV) of red blood cells. Cotransport rate was determined in unfractionated and density-separated red cells of different MCV from different donors to see whether cotransport differences contribute to the difference in the distribution of MCVs. Cotransport, studied in cells at their original MCVs, was determined as the bumetanide (10 ~.M)-sensitive 2~Na efflux in the presence of ouabain (50 I~M) after adjusting cellular Na (Nai) and K~ to achieve near maximal transport rates. This condition was chosen to rule out MCV-related differences in Nai and Ki that might contribute to differences in the net chemical driving force for cotransport. We found that in both unfractionated and density-separated red cells the cotransport rate was inversely correlated with MCV. MCV was correlated directly with red cell 2,3-diphosphoglycerate (DPG), whereas total red cell Mg was only slightly elevated in cells with high MCV. Thus intraceUular free Mg (Mg~ e) is evidently lower in red cells with high 2,3-DPG (i.e., high MCV) and vice versa. Results from flux measurements at their original MCVs, after altering Mg[ r~ with the ionophore A23187, indicated a high Mgi sensitivity of cotransport: depletion of M~ r~ inhibited and an elevation of M~ tee increased the cotransport rate. The apparent K05 for Mg~ e" was ~ 0.4 mM. Maximizing Mig~ ~ at optimum Nai and I~ minimized the differences in cotransport rates among the different donors. It is concluded that the relative cotransport rate is regulated for cells in the steady state at their original cell volume, not by the number of copies of the cotransporter but by differences in Mig~ ~. The interindividual differences in Mg~ ~, determined primarily by differences in the 2,3-DPG content, are responsible for the differences in the relative cotransport activity that results in an inverse Address reprint requests to Dr.