Energy depletion increases the renal production of 2=,3=-cAMP (a positional isomer of 3=,5=-cAMP that opens mitochondrial permeability transition pores) and 2=,3=-cAMP is converted to 2=-AMP and 3=-AMP, which in turn are metabolized to adenosine. Because the enzymes involved in this "2=,3=-cAMP-adenosine pathway" are unknown, we examined whether 2=,3=-cyclic nucleotide 3=-phosphodiesterase (CNPase) participates in the renal metabolism of 2=,3=-cAMP. Western blotting and real-time PCR demonstrated expression of CNPase in rat glomerular mesangial, preglomerular vascular smooth muscle and endothelial, proximal tubular, thick ascending limb and collecting duct cells. Real-time PCR established the expression of CNPase in human glomerular mesangial, proximal tubular and vascular smooth muscle cells; and the level of expression of CNPase was greater than that for phosphodiesterase 4 (major enzyme for the metabolism of 3=,5=-cAMP). Overexpression of CNPase in rat preglomerular vascular smooth muscle cells increased the metabolism of exogenous 2=,3=-cAMP to 2=-AMP. Infusions of 2=,3=-cAMP into isolated CNPase wild-type (ϩ/ϩ) kidneys increased renal venous 2=-AMP, and this response was diminished by 63% in CNPase knockout (Ϫ/Ϫ) kidneys, whereas the conversion of 3=,5=-cAMP to 5=-AMP was similar in CNPase ϩ/ϩ vs. Ϫ/Ϫ kidneys. In CNPase ϩ/ϩ kidneys, energy depletion (metabolic poisons) increased kidney tissue levels of adenosine and its metabolites (inosine, hypoxanthine, xanthine, and uric acid) without accumulation of 2=,3=-cAMP. In contrast, in CNPase Ϫ/Ϫ kidneys, energy depletion increased kidney tissue levels of 2=,3=-cAMP and abolished the increase in adenosine and its metabolites. In conclusion, kidneys express CNPase, and renal CNPase mediates in part the renal 2=,3=-cAMPadenosine pathway.2=,3=-cyclic adenosine monophosphate; 2=-adenosine monophosphate; 3=-adenosine monophosphate; adenosine; 2=,3=-cyclic nucleotide 3=-phosphodiesterase; CNPase IN RESPONSE TO INJURY, RAT (27,45) and mouse (25) kidneys can produce 2=,3=-cAMP, a positional isomer of 3=,5=-cAMP that is generated when mRNA is enzymatically degraded (27). Moreover, kidneys metabolize 2=,3=-cAMP to 2=-AMP and 3=-AMP and convert 2=-AMP and 3=-AMP to adenosine (25,27). This sequence of reactions is called the "2=,3=-cAMP-adenosine pathway" (2=,3=-cAMP ¡ 2=-AMP ϩ 3=-AMP ¡ adenosine).It is conceivable that the 2=,3=-cAMP-adenosine pathway is a determinant of outcomes following acute injury kidney (AKI). In this regard, work by Azarashvili et al. (2) shows that 2=,3=-cAMP opens mitochondrial permeability transition pores (MPTPs), and it is well-established that a high level of opening of MPTPs leads to apoptosis and necrosis (30); MPTP opening may be particularly important in the pathophysiology AKI (6, 7, 37, 52). On the other hand, it is also conceivable that a moderate level of MPTP activation preconditions organ systems and thus protects against tissue injury (47). Studies also suggest that adenosine may protect against AKI. For example, pivotal studies by ...