The role of Na+/H+ exchanger 3 (NHE3) in the kidney in angiotensin II (ANG II)-induced hypertension remains unknown. The present study used global NHE3-deficient mice with transgenic rescue of the Nhe3 gene in small intestines (tgNhe3(-/-)) to test the hypothesis that genetic deletion of NHE3 selectively in the kidney attenuates ANG II- induced hypertension. Six groups of wild- type (tgNhe3(+/+))and tgNhe3(-/-) mice were infused with either vehicle or ANG II (1.5 mg/kg/day, i. p., 2 weeks, or 10 nmol/min, i. v., 30 min), treated with or without losartan (20 mg/kg/day, p. o.) for 2 weeks. Basal systolic blood pressure (SBP) and mean intra- arterial blood pressure (MAP) were significantly lower in tgNhe3(-/-) mice (P < 0.01). Basal glomerular filtration rate, 24 h urine excretion, urinary Na+ excretion, urinary K+ excretion, and urinary Cl- excretion were significantly lower in tgNhe3(-/-) mice (P < 0.01). These responses were associated with significantly elevated plasma ANG II and aldosterone levels, and marked upregulation in aquaporin 1, the Na+/HCO3 cotransporter, the a1 subunit isoform of Na+/K+ ATPase, protein kinase Ca, MAP kinases ERK1/2, and glycogen synthase kinase 3 a/b in the renal cortex of tgNhe3(-/-) mice (P < 0.01). ANG II infusion markedly increased SBP and MAP and renal cortical transporter and signaling proteins in tgNhe3(+/+), as expected, but all of these responses to ANG II were attenuated in tgNhe3(-/-) mice (P < 0.01). These results suggest that NHE3 in the kidney is necessary for maintaining normal blood pressure and fully developing ANG II-dependent hypertension.