Gentamicin nephrotoxicity was examined in rats on normal, high, and low sodium diets. Low sodium diet markedly potentiated nephrotoxic effects of the drug as evidenced by animal mortality, renal failure, pathological changes, and increased renal cortical concentration of the drug. High sodium intake reduced the cortical concentration of gentamicin but renal function and ultrastructure were similar to normally fed rats given in the same dose.