Megalin, a 600 kDa membrane protein belonging to the IDL receptor family is highly expressed in the endocytic pathway of renal proximal tubules. In addition, this receptor is found in several other epithelia facing transcellular fluids but is also expressed in the parathyroid glands. Recent studies have established this protein as probably the most important receptor for endocytosis of macromolecules filtered in the renal glomeruli. The ligands reported to bind to megalin consist of a variety of different substances including albumin, vitamin-carrier complexes, proteinases and proteinase-inhibitor complexes, lipoprotein particles, receptor associated protein (RAP), different drugs and calcium.