Ammonium (NH4+) excretion varies appropriately with changes in acid-base balance and represents the major regulatable component of net acid excretion. The transport of ammonium can occur by 'diffusion trapping', or active H+ secretion in parallel with passive NH3 diffusion. In addition, direct NH4+ transport is important in many nephron segments. Since NH4+ and K+ have a similar hydrated radius, these ions share common transport pathways in many renal and nonrenal cell types. For example, these ions compete for a common binding site on the Na,K-ATPase. In addition to Na+ pump-mediated NH4+ transport, the Na,K-ATPase generates an electrochemical gradient across the cell membrane which affects other H+ and NH4+ transport pathways. In this review, the role of the Na+ pump on each of these renal ammonium transport mechanisms will be reviewed.