SUMMARY Accumulating experimental evidence suggests that natrjuresis in response to intravascular volume expansion is promoted by an endogenous regulator of Na + ,K + -adenosine triphosphatase (ATPase). Efforts to purify this substance by a number of laboratories have as yet been unsuccessful. The properties of partially purified inhibitors from plasma, urine, and tissue often fall to possess the characteristics thought to be consistent with those of a physiological regulator. These include potency (K, of approximately 1 nM), reversibility of inhibition, specificity for Na + ,K + -ATPase, and responsiveness to relevant physiological stimuli. Two rather different candidate substances, extracted from urine and hypotbalamus, have been purified to a high degree. Neither is a peptide, and both are of low molecular weight and resistant to acid hydrolysis. The substance from urine is rather nonpolar and interacts with digoxin-specific antibodies, while that from hypothalamus is polar and does not appear to share epitopes with the cardiac glycosides. On the serosal surface of the toad urinary bladder, the hypothalamic substance causes a reversible inhibition of Na + transport, inhibits rubidium uptake in red blood cells by acting on the membrane's exterior surface, inhibits binding of ouabain to purified Na + ,K + -ATPase, and reversibly inhibits hydrolysis of adenosine S'-triphosphate by the enzyme with a A', of 1.4 nM. The hypothalamic inhibitor may be differentiated from ouabain by their respective ionic requirements for optimal inhibition of enzymatic activity, and although both ouabain and the hypothalamic inhibitor fix Na + ,K + -ATPase in its Ej conformation, the hypothalamic inhibitor does not promote phosphoryiation of the enzyme by inorganic phosphate in the presence of