Hypertension is a critical public health issue worldwide, and in the United States, it is the leading cause of heart disease, stroke, and kidney failure, contributing to more than 1,100 deaths per day. It is proposed that the renal medulla combats increased blood pressure by releasing a neutral lipid from the lipid droplets of medullary interstitial cells, termed medullipin, which induces diuresis- natriuresis and vasodepression. The renal medulla is enriched with fatty acid lipid ethanolamides including the endocannabinoid anandamide (AEA), palmitoylethanolamide (PEA), and oleoylethanolamide (OEA), along with their primary hydrolyzing enzyme fatty acid amide hydrolase (FAAH). Our lab is investigating the relationship of these lipid ethanolamides and their metabolites to medullipin. We have shown that intramedullary infusion of AEA stimulated diuresis-natriuresis without changing mean arterial pressure (MAP) in an acute surgical model using anesthetized normotensive C57BL/6J mice. The hypothesis that infusion of a FAAH-selective inhibitor, PF-3845, would produce similar responses as exogenous AEA was tested. Intramedullary infusion of PF-3845 stimulated diuresis-natriuresis, decreased MAP, and increased lipid ethanolamide concentrations in kidney tissue in C57BL/6J mice. Since the decrease in MAP observed with PF-3845 was not consistent with the results of exogenous AEA, this study hypothesized that increased PEA concentrations in the renal medulla observed with PF-3845 produced the decrease in MAP. Therefore, the effects of PEA administration into the renal medulla were investigated. Intramedullary infusion of PEA stimulated diuresis and natriuresis without changing MAP in normotensive C57BL/6J mice. However, intramedullary PEA administration to mice made hypertensive using L-NAME, an inhibitor of nitric oxide synthase, was assessed. Intramedullary infusion of PEA stimulated diuresis, but also decreased MAP in L-NAME-induced hypertensive mice. The mechanism of PEA-induced diuresis was evaluated for the contributions of its FAAH-mediated hydrolysis and the CB1 receptor. Intramedullary infusion of PEA stimulated diuresis in FAAH knockout mice and CB1 knockout mice. The possible source of PEA in the renal medulla was investigated using renal medullary interstitial cells cultured from mice. In cultured mouse medullary interstitial cells (MMICs), treatment with PF-3845 increased cytoplasmic lipid droplets detected by Sudan Black B (SBB) staining and increased PEA in the culture medium. Physiologic stimuli that may regulate PEA production and release from MMICs were also evaluated. Increased osmolarity increased NAPE-PLD protein levels, increased SBB stained droplets in MMICs, and increased PEA concentrations in the culture medium. Overall, it is concluded that the PEA-induced diuretic and natriuretic effect is independent of FAAH-mediated hydrolysis and the CB1 receptor, and that PEA can serve as an antihypertensive regulator in the renal medulla that may be regulated by medullary interstitial cells.