Background ob/ob mice are a leptin deficient murine model of type 2 diabetes mellitus (T2DM), characterized by hyperphagia, obesity and hyperglycemia. ob/ob mice on a BTBR background have enhanced insulin resistance and mimic the glomerular pathophysiology of diabetic nephropathy (DN) in humans. However, leptin deficiency reduces blood pressure (BP). Since reduced activity of endothelial nitric oxide synthase (eNOS) enhances BP and the progression of kidney disease, we attempted to develop a more robust DN model by introducing eNOS deficiency in BTBR ob/ob mice. Methods BTBR mice heterozygous for both ob and eNOS were bred to generate 6 experimental groups being wild-type for Ob (Con) or ob/ob (Ob) as well as wild-type (WT), heterozygote (HET) or knockout (KO) for eNOS: Con/WT, Con/HET, Con/KO, Ob/WT, Ob/HET & Ob/KO. Systolic BP (automated tail-cuff) and GFR (FITC sinistrin plasma kinetics) were determined in awake mice in weeks 27-30 followed by kidney harvest for RTqPCR analysis of injury markers. Statistics: 2-way ANOVA for Ob and eNOS followed by pairwise comparisons if interaction was significant. 13-24 mice (males plus females)/group for WT and HET, n= 5-8 mice/group for KO. Results In WT, Ob increased blood glucose (BG), body weight (Bw), kidney weight (Kw), GFR, and urinary albumin to creatinine ratio (UACR), and reduced BP vs Con. These responses to Ob were not different in HET. KO increased BP and UACR and reduced Kw and GFR vs WT in both Con and Ob. In Ob, KO reduced BG and Bw vs WT. All effects were independent of gender. In male mice: In WT, Ob increased renal mRNA expression of Ngal, Ccl2, and Timp1, whereas Kim1, Tnfa and Col1a1 were not significantly different vs Con. These responses to Ob were similar in HET. KO increased renal mRNA expression of Ngal, Timp1, Col1a1 vs WT in both Con and Ob; and KO, in addition, also increased Kim1, Ccl2 and Tnfa vs WT in Ob. In female mice: In WT, Ob did not change renal mRNA expression of Ngal, Ccl2, Timp1, and Tnfa and the expression of Kim1 and Col1a1 were actually reduced vs Con. Similar responses to Ob were observed in HET. KO increased renal mRNA expression of Ngal, Ccl2, Timp1, and Col1a1 vs WT in both Con and Ob; and KO in addition increased Tnfa vs WT in Ob. Conclusions Male and female BTBR ob/ob mice at 27-30 weeks of age presented hyperglycemia and increased Bw associated with larger kidneys, glomerular hyperfiltration and a 100x higher UACR vs Con. These effects were associated with modest increases in renal mRNA expression of Ngal, Ccl2, and Timp1 only in male mice, whereas female Ob mice unexpectedly had lesser expression of Kim1 and Col1a1 vs Con. eNOS heterozygosity did not induce robust renal changes vs WT in Con or Ob. In contrast, eNOS KO, which increased BP by 15-25 mmHg, enhanced kidney injury as indicated by lesser Kw and GFR, associated with higher UACR and renal mRNA expression of markers of injury, inflammation and fibrosis, and lower survival rates; these effects of eNOS KO were detectable in Con and more pronounced in Ob.