BACKGROUND: Nephrotoxicity of cancer therapy using radiolabeled somatostatin analogues such as octreotide is due to ultrafiltration and reuptake by proximal tubular cells (PTCs). The mechanism of uptake is unknown. It could occur either by receptor-mediated endocytosis via a somatostatin receptor or, alternatively, the multiligand megalin/cubilin tandem receptor, or by fluid-phase endocytosis. To define the mechanisms of internalization and to identify potential receptors, we have studied the uptake and processing of octreotide by the PTC-derived opossum kidney (OK) cell line. METHODS: We compared the kinetics of uptake and fate of (111)In-diethylenetriamine pentaacetic acid (DTPA)-D-Phe(1)-octreotide and (125)I-human serum albumin ((125)I-...