Li+ is actively transported out of cells, and across different epithelia of both mammalian and amphibian origin. Due to the low affinity of the Na+/K(+)-ATPase for Li+, the transport is most likely energized by exchange and/or cotransport processes. The detailed mechanism by which Li+ is reabsorbed across the proximal tubule is not known, although it seems reasonable to assume that at least a part is by secondary active transcellular transport. The evidence further suggest that aldosterone and maybe vasopressin, through their effects on the Na+ channels in the late distal tubule and the collecting duct may be of significance in inducing distal Li+ reabsorption, as seen during severe sodium restriction in rats and dogs. Clearly more studies are needed to finally resolve these issues.