The intrarenal renin-angiotensin system (RAS) plays an important role in the progression of diabetic nephropathy. We have previously reported that mice overexpressing angiotensinogen in renal proximal tubular cells (RPTC) develop hypertension, albuminuria, and renal injury. Here, we investigated whether activation of the intrarenal RAS contributes to apoptosis of RPTC in diabetes. Induction of diabetes with streptozotocin in these transgenic mice led to significant increases in BP, albuminuria, RPTC apoptosis, and proapoptotic gene expression compared with diabetic nontransgenic littermates. Insulin and/or RAS blockers markedly attenuated these changes. Hydralazine prevented hypertension but not albuminuria, RPTC apoptosis, or proapoptotic gene expression. In vitro, high-glucose medium significantly increased apoptosis and caspase-3 activity in rat immortalized RPTC overexpressing angiotensinogen compared with control cells, and these changes were prevented by insulin and/or RAS blockers. In conclusion, intrarenal RAS activation and high glucose may act in concert to increase tubular apoptosis in diabetes, independent of systemic hypertension. Diabetic nephropathy (DN) is the leading cause of all ESRD in North America, accounting for 45% to 50% of all cases. 1,2 Intensive insulin therapy and chronic treatment with renin-angiotensin system (RAS) blockers are effective in retarding DN progression but do not provide a cure. [3][4][5] The local intrarenal RAS is well accepted. 6,7 Renal proximal tubular cells (RPTC) express all components of the RAS. 8 -10 Angiotensin II (Ang II) levels and RAS genes are elevated in the kidneys of diabetic rats and humans, 11-13 implying an important role for the intrarenal RAS in DN progression.Glomerular changes in DN first consist of hypertrophy and, later, thickening of the glomerular basement membrane, followed by expansion of the mesangial matrix and glomerulosclerosis. 14 -16 However, the gradual decline of renal function in later stages of DN is invariably associated with tubular atrophy and interstitial fibrosis, hallmarks of ESRD. 17,18 In fact, tubular atrophy and interstitial fibrosis are closely associated with loss of renal function and appear to be better predictors of renal disease progression than glomerular pathology. 15-18 Tubular atrophy in DN is incompletely understood, although apoptosis is a candidate mechanism. Indeed, apoptosis has been detected in RPTC of diabetic mouse, rat, and human kidneys. 19 -24