Aldose reductase (ALR2), a NADPH-dependent aldo-keto reductase (AKR), is widely distributed in mammalian tissues and has been implicated in complications of diabetes, including diabetic nephropathy. To identify a renal-specific reductase belonging to the AKR family, representational difference analyses of cDNA from diabetic mouse kidney were performed. A full-length cDNA with an ORF of 855 nt and yielding a Ϸ1.5-kb mRNA transcript was isolated from a mouse kidney library. Human and rat homologues also were isolated, and they had Ϸ91% and Ϸ97% amino acid identity with mouse protein. In vitro translation of the cDNA yielded a protein product of Ϸ33 kDa. Northern and Western blot analyses, using the cDNA and antirecombinant protein antibody, revealed its expression exclusively confined to the kidney. Like ALR2, the expression was up-regulated in diabetic kidneys. Its mRNA and protein expression was restricted to renal proximal tubules. The gene neither codistributed with Tamm-Horsfall protein nor aquaporin-2. The deduced protein sequence revealed an AKR-3 motif located near the N terminus, unlike the other AKR family members where it is confined to the C terminus. Fluorescence quenching and reactive blue agarose chromatography studies revealed that it binds to NADPH with high affinity (KdNADPH ؍ 66.9 ؎ 2.3 nM). This binding domain is a tetrapeptide (Met-Ala-Lys-Ser) located within the AKR-3 motif that is similar to the other AKR members. The identified protein is designated as RSOR because it is renal-specific with properties of an oxido-reductase, and like ALR2 it may be relevant in the renal complications of diabetes mellitus.diabetes mellitus ͉ diabetic nephropathy R enal complications are a common manifestation of diabetes mellitus. Characteristics of these complications are an increase of extracellular matrix (ECM) proteins, i.e., type I and type IV collagens and decorin and fibronectin, synthesized by glomerular, tubular, and interstitial cells (1). The increase in ECM may be multifactorial, but recent studies have narrowed it down to two or three pathogenetic mechanisms that are affected by hyperglycemia. The hyperglycemia may increase the mRNA expression and bioactivity of certain cytokines that modulate the synthesis of various ECM proteins, e.g., transforming growth factor  (2, 3). Nonenzymatic glycation is another mechanism by which various Amadori intermediaries lead to the generation of advanced glycation products (AGEs). The AGEs further crosslink the glycated proteins with one another and render them extremely resistant to proteolytic degradation, resulting in an accumulation of ECM in the kidney (4). Such an AGE-mediated cross-linking process is not restricted to the kidney tissue proteins alone, but it affects other tissue proteins as well, e.g., ocular lens crystallins (5, 6). Another mechanism that is also relevant to diabetic nephropathy is the polyol pathway, which consists of two major reactions. First, glucose is reduced by aldose reductase (ALR2) to sorbitol by using NADPH as the hydrogen...