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Endogenous cardiotonic glycosides bind to the inhibitory binding site of the plasma membrane sodium pump (Na⁺/K⁺-ATPase). Plasma levels of endogenous cardiotonic glycosides increase in several disease states, such as essential hypertension and uremia. Low concentrations of ouabain, which do not inhibit Na⁺/K⁺-ATPase, induce cell proliferation. The mechanisms of ouabain-mediated response remain unclear. Recently, we demonstrated that in opossum kidney (OK) proximal tubular cells, low concentrations of ouabain induce cell proliferation through phosphorylation of protein kinase B (Akt) in a calcium-dependent manner. In the present study, we identified ERK as an upstream kinase regulating Akt activation in ouabain-stimulated cells. Furthermore, we provide evidence that low concentrations of ouabain stimulate Na⁺/K⁺-ATPase-mediated ⁸⁶Rb uptake in an Akt-, ERK-, and Src kinase-dependent …