The concentration of urea in renal medullary cells is high enough to affect enzymes seriously by reducing V max or raising K m , yet the cells survive and function. The usual explanation is that the methylamines found in the renal medulla, namely glycerophosphocholine and betaine, have actions opposite to those of urea and thus counteract its effects. However, urea and methylamines have the similar (not counteracting) effects of reducing both the K m and V max of aldose reductase (EC 1.1.1.21), an enzyme whose function is important in renal medullas. Therefore, we examined factors that might determine whether counteraction occurs, namely different combinations of assay conditions (pH and salt concentration), methylamines (glycerophosphocholine, betaine, and trimethylamine N-oxide), substrates (DLglyceraldehyde and D-xylose), and a mutation in recombinant aldose reductase protein (C298A). We find that V max of both wild-type and C298A mutant generally is reduced by urea and͞or the methylamines. However, the effects on K m are much more complex, varying widely with the combination of conditions. At one extreme, we find a reduction of K m of wild-type enzyme by urea and͞or methylamines that is partially additive, whereas at the other extreme we find that urea raises K m for D-xylose of the C298A mutant, betaine lowers the K m , and the two counteract in a classical fashion so that at a 2:1 molar ratio of betaine to urea there is no net effect. We conclude that counteraction of urea effects on enzymes by methylamines can depend on ion concentration, pH, the specific methylamine and substrate, and identity of even a single amino acid in the enzyme.High concentrations of urea are present in the tissues of marine elasmobranchs and in the mammalian renal medulla. Urea generally destabilizes biological macromolecules, altering their structure and function. Such effects are expected to be deleterious. However, the urea-rich tissues also contain high concentrations of certain methylamine compounds, principally trimethylamine N-oxide (TMAO) in elasmobranchs (1) and glycine betaine (betaine) and glycerophosphocholine (GPC) in mammalian renal medulla (2). These methylamines are believed to protect the cells from urea by stabilizing macromolecules and thus counteracting the actions of urea. The two effects are independently additive (1, 3). When the ratio of methylamines to urea is appropriate (often 1:2), their opposing effects are reported to counteract, preserving macromolecular structure and function. The theory of counteracting osmolytes is strongly supported by the occurrence of methylamines in organisms and tissues containing high concentrations of urea (4), by survival in tissue culture of cells containing high levels of both urea and betaine, compared with the poor survival of cells containing only one or the other (5), and by many observations on isolated macromolecules in vitro (4).However, we recently found that three different methylamines, namely TMAO, betaine, and GPC, do not counteract inhibition by ure...