Chronic kidney disease has now become a public health problem worldwide. National and international epidemiological survey data show that diabetic patients are a high-risk group for developing chronic kidney disease. With the change of lifestyle, the number of diabetic patients in developed and developing countries is rapidly increasing year by year. Multiple organ damage can occur in patients with advanced diabetes mellitus. The kidney is an important organ involved, mainly due to diabetic microangiopathy, called diabetic nephropathy. In addition, diabetic patients are often accompanied by hypertension, coronary heart disease and obesity, which are also involved in kidney damage in diabetic patients. Currently, diabetes has become the leading cause of chronic kidney disease in developed countries such as Europe and the United States. In the United States, the incidence of microalbuminuria in patients with a history of diabetes is 43%, and the prevalence of dominant albuminuria is 8%. Forty-five percent of patients with end-stage renal disease are diabetic. With the increase of type 2 diabetes and obesity, diabetes is becoming a major cause of chronic kidney disease in developing countries. In the face of the increasing number of patients with diabetic nephropathy and the risk to human health, it is necessary to strengthen the prevention and treatment of diabetic nephropathy. Diabetic nephropathy has an insidious onset and is often not easily detected in the early stages without obvious symptoms. Once clinically significant proteinuria appears, patients are often poorly treated and quickly progress to renal failure. Therefore, early diagnosis and prevention are important to slow down the progression of renal function and reduce the number of patients entering ESRD. In 2007, the American Kidney Disease Foundation introduced the first clinical manual on diabetes and chronic kidney disease in the K/DOQI guidelines, suggesting that chronic kidney disease due to diabetes be named diabetic kidney disease (DKD). It also summarized five clinical practice guidelines and four clinical practice recommendations using an evidence-based approach by synthesizing the results of a large number of previous clinical research reports and systematic evaluations. Among them, the following recommendations are given for the screening and diagnosis of diabetic kidney disease: 1. Patients with type 1 diabetes should be screened for diabetic kidney disease 5 years after diagnosis, and patients with type 2 diabetes should be screened annually after the diagnosis is established. 2, screening indicators: (1) urine microalbumin measurement: this indicator is currently the earliest and most sensitive indicator for the diagnosis of diabetic kidney disease. It can be quantified by retaining urine for 24 hours, or by retaining urine for a period of time (e.g., 8 hours) to calculate the albumin excretion rate; or by retaining a single urine specimen at any time to detect albumin and creatinine concentration to calculate the albumin/creatinine ratio (ACR). The following are definitions of albuminuria: Classification Primary urine ACR (mg/g) 24-hour urine (mg/24 h) Period of urine (μg/min) Normal albuminuria Microalbuminuria Dominant albuminuria 300300200 At the time of urine retention the patient is required to exclude urinary tract infections. Since there is variability in urinary albumin excretion in the physiological state of the person (influenced by diurnal, exercise, blood glucose, etc.), it should be rechecked 1-2 times in the next 3-6 months. (2) Glomerular filtration rate (GFR): It is an important index to evaluate renal function. The estimated GFR can be calculated by measuring serum creatinine through a formula. When a patient is detected to have micro- or macroalbuminuria along with fundus examination confirming diabetic retinopathy, it is often considered that the patient’s kidney disease is attributed to diabetes, which we call diabetic nephropathy. Patients with non-diabetic nephropathy should be considered when they have: (1) lack of diabetic retinopathy; (2) rapidly declining renal function; (3) rapidly increasing proteinuria or nephrotic syndrome; (4) intractable hypertension; (5) active urinary sedimentation, such as with significant hematuria; (6) other systemic signs and symptoms; (7) administration of ACEI or ARB antihypertensive drugs A large number of clinical and basic studies have confirmed that strengthening the management of diabetic patients and early interventions can avoid the occurrence of diabetic kidney disease, reverse early damage and delay the progression. Specifically, these include: (1) blood glucose: hyperglycemia is the main cause of diabetic vasculopathy, and intensive control of blood glucose can prevent diabetic kidney disease and delay the progression of existing kidney disease. Patients are required to have a glycosylated hemoglobin (HbA1C) of less than 7.0%. (2) Blood pressure: diabetic patients mostly have hypertension, blood pressure control can delay the progression of chronic kidney disease, blood pressure should be controlled below 130/80mmHg. It is recommended to apply ACEI and ARB antihypertensive drugs, these two drugs have the effect of lowering blood pressure in addition to reducing proteinuria and protecting renal function. (3) Lipids: Diabetic patients often have disorders of lipid metabolism, which are involved in kidney damage, and at the same time make the occurrence of cardiovascular disease in this population greatly increased. It is recommended that LDL cholesterol <100mg/dl; if >100mg/dl it is recommended to apply statin therapy. (4) Low protein diet: the recommended protein intake is 0.8g/Kg/d, which can slow down the progression of chronic kidney disease. In conclusion, the prevention and treatment of diabetic kidney disease emphasizes comprehensive and multifaceted interventions, including healthy lifestyle and treatment to reduce risk factors. Meanwhile, scholars at home and abroad need to continue to search for clinical and experimental is indicators that predict early kidney damage and find new therapeutic tools.