F reshly isolated proximal tubules subjected to hypoxia/ reoxygenation (H/R) (1) develop a severe mitochondrial functional deficit (1,2) leading to persistent ATP depletion, which plays a pivotal role in overall cellular recovery (3). The energetic deficit occurs despite preserved electron transport (4) and minimal cytochrome c release (2). ATP recovery can be substantially improved by supplementing tubules with citric acid cycle metabolites such as ␣-ketoglutarate and malate individually and in combination (1-3).Mitochondrial membrane potential (⌬⌿ m ), as assessed by 5,5Ј,6,6Ј-tetrachloro-1,1Ј,3,3Ј-tetraethylbenzimidazocarbocyanine iodide (JC-1) uptake is consistently decreased, but not absent, in affected tubules and is restored by the protective citric acid cycle metabolites (1,2,4,5). However, the nonlinearity of formation of JC-1 red aggregates relative to ⌬⌿ m and their slow and incomplete dissociation back to monomers during de-energization limits the use of JC-1 to dynamically follow and manipulate the changes of ⌬⌿ m to gain more mechanistic information about the factors contributing to them (5). Safranin O is concentrated in the mitochondrial matrix as a linear function of ⌬⌿ m where its fluorescence is quenched, allowing its uptake and ⌬⌿ m to be followed by fluorescence changes (6-8). We have recently reported studies employing safranin O in digitonin-permeabilized tubule preparations to alternatively assess ⌬⌿ m in the model (5). Safranin O uptake by mitochondria in digitonin-permeabilized tubules required very small amounts of tubules, permitted measurements of ⌬⌿ m for relatively prolonged periods after the end of the experimental maneuvers, was rapidly reversible during de-energization, and allowed for direct assessment of both substrate-dependent, electron transport-mediated ⌬⌿ m and ATP hydrolysis-supported ⌬⌿ m . Both types of energization in mitochondria of permeabilized tubules measured using safranin O after H/R were impaired. Combining substrates and ATP substantially restored ⌬⌿ m , but did not fully normalize it (5). The objective of the studies reported here was to clarify the mechanism for the energetic deficit by further investigating the role of ATP in facilitating recovery of mitochondrial energization after H/R and determining whether abnormalities of the mitochondrial F 1 F O -ATPase (9,10) or of nucleotide delivery to it by the adenine nucleotide translocase are involved.