The mechanism(s) by which paraquat (1,1'-dimethyl-4,4'-bipyridinium), a divalent organic cation (OC) and proximal tubule nephrotoxicant, crosses renal cell membranes is unclear. The structurally-related monovalent OC, 1-methyl-4-phenylpyridinium (MPP+), crosses the renal brush border via OC/H+ exchange using the same pathway by which tetraethylammonium (TEA) is transported. We examined whether paraquat shares the TEA(MPP+)/H+ exchanger by examining 14C-paraquat transport in rabbit renal BBMV. Compared to a pH equilibrium condition (pH 7.5in:7.5o), an H-gradient (pH 6in:7.5o) stimulated the 5 s and 60 s uptakes of 230 microM paraquat by 51% and 108%, respectively, and this stimulation was blocked by both 20 mM unlabeled paraquat and TEA. Pre-loading BBMV with 2 mM unlabeled TEA (under conditions of pH equilibrium) stimulated by 3-fold the 60 s uptake of 120 microM paraquat and by 5 min produced a transient intravesicular accumulation of paraquat that exceeded equilibrium (2 h) uptake by 45%. The presence of 200 microM paraquat in the extravesicular solution competitively inhibited H-gradient-stimulated transport of 14C-TEA in renal BBMV, increasing the apparent Kt for TEA transport from 169 microM to 379 microM, without significantly influencing the Jmax (16.0 vs. 15.4 nmol mg-1 min-1). The calculated Ki for paraquat (presumably equal to its Kt for transport) after transport was between 160 and 220 microM (depending upon the method of estimation). Significantly, the Kt for MPP+/H exchange is 12 microM, suggesting that the affinity of the exchanger is profoundly influenced by the presence on paraquat of a second positive charge. We conclude that renal transport of paraquat involves the OC/H+ exchanger of proximal cell luminal membranes and that this pathway may play a role in the renal secretion of polyvalent organic cations.