The PO 2 within the kidney changes dramatically from cortex to medulla. The present experiments examined the effect of changing PO 2 on epithelial Na channel (ENaC)-mediated Na transport in the collecting duct using the mpkCCD-c14 cell line. Decreasing ambient O 2 concentration from 20 to 8% decreased ENaC activity by 40%; increasing O2 content to 40% increased ENaC activity by 50%. The O 2 effect required several hours to develop and was not mimicked by the acid pH that developed in monolayers incubated in low-O2 medium. Corticosteroids increased ENaC activity at each O 2 concentration; there was no interaction. The pathways for O2 and steroid regulation of ENaC are different since O2 did not substantially affect Sgk1, ␣-ENaC, Gilz, or Usp2-45 mRNA levels, genes involved in steroid-mediated ENaC regulation. The regulation of ENaC activity by these levels of O2 appears not to be mediated by changes in hypoxia-inducible factor-1␣ or -2␣ activity or a change in AMP kinase activity. Changes in O2 concentration had minimal effect on ␣-or ␥-ENaC mRNA and protein levels; there were moderate effects on -ENaC levels. However, 40% O2 induced substantially greater total -and ␥-ENaC on the apical surface compared with 8% O2; both subunits demonstrated a greater increase in the mature forms. The ␣-ENaC subunit was difficult to detect on the apical surface, perhaps because our antibodies do not recognize the major mature form. These results identify a mechanism of ENaC regulation that may be important in different regions of the kidney and in responses to changes in dietary NaCl.heat shock protein-70; heme oxygenase; adenosine 5=-monophosphate kinase; hypoxia-inducible factor-1␣; corticosteroids; surface expression THE OXYGEN TENSION OF THE renal parenchyma varies from that approaching the PO 2 of arterial blood near the surface of the kidney to considerably lower values in the midcortex (35). The PO 2 of the inner medulla is substantially below that of almost all normal tissues with values of 10 -15 Torr being routinely measured (4, 35). The relatively low PO 2 in both the cortex and the medulla is the result of a functional countercurrent exchange between arterioles and venules. The lower PO 2 in the medulla is believed to predispose to tubular injury in the setting of acute hemodynamic compromise, but the physiological consequences of the widely varying PO 2 of different regions is poorly understood.The collecting duct traverses the axis of the kidney from cortex to papillary tip and, consequently, is exposed to a wide range of PO 2 . It is well known that the rate of Na absorption by the cortical collecting duct is considerably greater than that by the medullary collecting duct (19,48). The reason for this regional difference in Na transport rate is not clear. Two possibilities have been proposed: hypertonicity and the high concentration of transforming growth factor- within the renal medulla (28). Another possibility is the O 2 tension: low PO 2 in lung epithelial cells reduces epithelial Na channel (ENaC) activity (...