Disturbed renal handling of prorenin and renin [(pro)renin] may result in hypertension and renal damage. Megalin is a major endocytic receptor playing an essential role in nutrient reabsorption. Genetic mutations resulting in impaired expression or trafficking of megalin in patients with Dent’s disease or Lowe syndrome caused a 20-40-fold rise of urinary renin levels. Interestingly, the urine of such patients also contained prorenin, which normally is undetectable in urine. Moreover, inhibiting megalin in rodents massively upregulated urinary renin levels. The aim of this study was to investigate (pro)renin binding and internalization by megalin. Immortalized Brown Norway Rat yolk sac cells (BN16) were used, since they abundantly express megalin. To distinguish binding and internalization, cells were incubated at 4°C and 37°C, respectively, with 1000 U/L recombinant human (pro)renin for up to 24 hours. (Pro)renin levels were assessed using an immunoradiometric assay. At 4°C, BN16 cells bound 3 times more prorenin than renin (14184.0±2626.0 vs. 4795.0±986.5 pg/mg of protein, p=0.0155), suggestive for a higher affinity of prorenin. Similarly, at 37°C, prorenin accumulated at 3-fold higher levels than renin in BN16 cells. Consequently, depletion of medium prorenin (but not renin) content occurred after 24 hours. Mannose-6-phosphate (M6P), an antagonist of the (pro)renin-binding M6P receptor, did not affect cellular (pro)renin uptake. Yet, inhibiting megalin expression using siRNAs reduced (pro)renin binding and internalization by >50%. Furthermore, treating cells with albumin, an endogenous ligand of megalin, also decreased binding and internalization of (pro)renin. Exposing prorenin’s prosegment with the renin inhibitor aliskiren dramatically increased prorenin binding, while after prosegment cleavage with trypsin prorenin binding was identical to that of renin. In conclusion, megalin is a novel endocytic receptor for (pro)renin which determines urinary (pro)renin levels. Megalin displays selectivity towards prorenin in a prosegment-dependent manner, and this explains why urine normally does not contain prorenin, except under conditions where megalin trafficking is disturbed.