Thyroid hormone stimulates renal proximal tubule NaCl and NaHCO 3 absorption in part by activating the apical membrane Na/H exchanger NHE3. We used a renal epithelial cell line, the opossum kidney (OK) cell, to define the mechanism by which 3,5,3′-triiodothyronine (T 3 ) increases NHE3 activity. T 3 stimulated NHE3 activity, an effect that was blocked by inhibition of cellular transcription or translation. The increase in activity was associated with increases in steady-state cell surface and total cellular NHE3 protein and NHE3 transcript abundance. T 3 stimulated transcription of the NHE3 gene and had no effect on NHE3 transcript stability. The transcriptional activity of the 5′-flanking region of the rat NHE3 gene was stimulated by T 3 when expressed in OK cells. When heterologously expressed rat NHE3 transcript levels were clamped constant with a constitutive promoter in OK cells, T 3 has no effect on rat NHE3 protein abundance, suggesting the absence of regulation of NHE3 protein stability or translation. These studies demonstrate that T 3 stimulates NHE3 activity by activating NHE3 gene transcription and increasing NHE3 transcript and protein abundance.Keywords proximal tubule; acid-base balance; NaCl homeostasis; development; promoter Sodium Chloride and NaHCO 3 absorption in the mammalian renal proximal tubule is affected by the thyroid status of the animal (10,11,21,22). The developmental maturation of proximal tubule NaCl and NaHCO 3 absorption is temporally preceded by an increase in circulating thyroid hormone levels (29). A significant portion of proximal tubule NaCl and NaHCO 3 transport is mediated by apical membrane Na/H exchange (24,25). Na/H exchange activity in renal cortical apical membrane vesicles is increased in hyperthyroid and decreased in hypothyroid animals (18,19). Although the effect on apical membrane Na/H exchange may be mediated in part by changes in glomerular filtration rate, systemic hemodynamic and/or neurohumoral changes (17), a direct effect of thyroid hormone on the maximum velocity (V max ) of the Na/H exchanger has been demonstrated in a cell culture model of the proximal tubule, the opossum kidney (OK) cell (30). With the identification of Na/H exchanger isoform cDNAs (reviewed in Ref. 28), specific reagents are now available to address the mechanisms of regulation of proximal tubule Na/H exchange. The predominant isoform responsible for proximal tubule apical membrane Na/H exchange is NHE3 (1, 6), and an opossum NHE3 homologue is expressed in OK cells. Most chronic biological effects of thyroid hormone are believed to be mediated via activation of gene transcription (26). However, one study in rat kidney showed that changes in the NHE3 transcript in response to thyroid hormone are not accompanied by changes in NHE3 protein abundance, raising doubts as to the role of increased NHE3 transcript in mediating the increased NHE3 activity (2). In the present study, we found that thyroid hormone administration to adult rats increases both apical membrane Na/H exchanger ...