In the advanced stage of diabetic nephropathy, the number of renal units that can play a role in the function is getting smaller and smaller, and there is insufficient excretion of wastes produced by the body metabolism, and at the same time, the balance of water, electrolyte, and acid-alkaline balance in the body is also out of order. In this serious stage, patients generally combined with cardiovascular, neurological, and systemic organ damage, common hypertension, arrhythmia, serious with heartbeat, shortness of breath, can not lie down (heart failure) limb ischemia and necrosis, numbness of the hand, foot numbness, vision …… and so on. Diabetic nephropathy kidney failure, in addition to the patient in accordance with the damage to the organs to give reasonable treatment, the way out of renal failure must rely on peritoneal dialysis, hemodialysis, or kidney transplantation, if all aspects of the conditions are better, it is best to strive to do pancreas-kidney transplantation, not only to solve the problem of diabetes, but also cured the renal failure. In order to have a greater chance of success in transplantation, adequate dialysis is usually done before transplantation to improve the patient’s health condition. Therefore, dialysis still needs to be considered. Which dialysis method is suitable for diabetic kidney failure? There is no absolute rule in medicine and the choice should be based on the patient’s specific condition. For example, if the patient is young, in good physical condition, without hypertension and cardiovascular complications, the patient can choose voluntarily: if the home hemodialysis center is closer and the transportation is convenient, the patient may choose hemodialysis; if the home is far away and the transportation to the dialysis center is inconvenient, the patient may choose home dialysis (peritoneal dialysis) of course. And busy people, can not find time to go to the hospital during the day to do hemodialysis, but also naturally choose home evening dialysis (with the help of automatic machine dialysis, do not have to be guarded, sleep as usual). Another example is the old, the frail, or with high blood pressure, heart disease, ulcer bleeding, often difficult to tolerate hemodialysis, often by the doctor’s decision, decided to choose peritoneal dialysis. Then there is a part of the diabetic, although the renal function has been poor, but also in azotemia or worse, just have some additional diseases suddenly appeared, such as lung infection, diarrhea, etc., provoked the rapid aggravation of the condition, into the uremic stage. At this time, if efforts to treat, eliminate these additional diseases, control the normal range of blood glucose, renal function will gradually improve, this dialysis method are desirable. However, the patient’s urine output is still high (i.e., there is a certain amount of residual renal function), and it is estimated that the patient will have to undergo dialysis for a longer period of time (can renal function be reversed?). When the situation is not clear), in order to preserve the remaining valuable renal function, it is appropriate to choose peritoneal dialysis. Modern medicine emphasizes a lot on the protection of residual renal function, because the existence of residual renal function will make the dialysis effect better, that is to say, make the patient’s quality of life higher and live more comfortably. Peritoneal dialysis has more superiority than hemodialysis in protecting residual kidney function. When is the best time for dialysis? Dialysis should be done at the early stage of renal failure in diabetic nephropathy. Blood creatinine >530 micromol/liter, if there are complications of diabetes, such as neuritis, cardiovascular disease, blood creatinine >442 micromol/liter should be dialyzed. Some foreign experts compare early dialysis and late dialysis, and prove that early dialysis is not only effective, but also has fewer complications of diabetes, and the complications that existed during dialysis can be alleviated or not develop for a long time, while late dialysis has more comorbidities, and after long-term dialysis, the physical condition and other aspects are poorer than that of the people with early dialysis, and the people with diabetic renal failure should be fully cognizant of this point.