A B S T R A C T At 48 h after bilateral nephrectomy in rats there is a two-to threefold increase in the number of adrenal angiotensin II receptors and a decrease in Kd of smooth muscle angiotensin II receptors. These changes have been attributed to the absence of circulating angiotensin II. Serum K+, which increases after nephrectomy may be an important and overlooked modulator. Therefore, the present experiments were designed to assess the role of K+ as a regulator of angiotensin II receptors after nephrectomy. Serum K+ was controlled with Na polystyrene sulfonate (Kayexalate), a resin designed to exchange Na+ for K+ in the gastrointestinal tract. Acutely nephrectomized rats were divided into two groups: experimental animals received Kayexalate resin every 12 h for four doses, and controls received Kayexalate exchanged with KC1 in vitro before gavage. There was a significant positive correlation serum K+ and aldosterone (r = 0.78, P < 0.001). Keyexalate maintained a normal serum K+ of 5.9±+0.2 meq/liter (n = 27), aldosterone 25+3 ng/dl (n = 27) and adrenal receptor concentration of934+ 156 fmol/mg protein (n = 4). Control animals had significantly higher serum K+ of 10.5+0.4 meq/liter (n = 23), aldosterone 435+32 (n = 23), and adrenal receptors of 2726±235 fmol/mg protein (n =4). There was a linear relationship between serum K+ and number of adrenal receptors (r = 0.87). No such relationship was present in uterine smooth muscle. Therefore, these studies demonstrate that K+ modulates the number of adrenal but not smooth muscle angiotensin II