Some data show that when a country’s per capita GDP reaches 700-1700 USD, it is the period of high prevalence of diabetes, and China is currently in this stage. In particular, since the reform and opening up, China’s economic development has progressed by leaps and bounds, and people’s living standards have increasingly improved, resulting in an increasing proportion of obese people, coupled with a longer life expectancy and an aging population, which has become an important cause of type 2 diabetes. Currently, the prevalence of diabetes in China is above 5% and the number of patients is the second highest in the world after India. It is well known that diabetes and its complications are extremely dangerous, and nephropathy is one of them. The ultimate trend is the progressive development of chronic renal failure and uremia, which are the primary and important causes of death in type 1 and type 2 diabetes, respectively, and diabetic nephropathy has become a serious public health problem. Diabetic nephropathy has an insidious onset, and once there is obvious proteinuria, swelling and creatinine elevation, it enters the rapid progression stage of renal decompensation, and early prevention and treatment can effectively slow down the progression of renal damage. For this reason, all diabetic friends should pay attention to kidney damage early. So what is diabetic nephropathy and how should it be monitored in the early stage? Diabetic nephropathy is a microvascular complication of diabetes. Due to long-term hyperglycemia in the body, diabetic patients have damage to microcirculation, which is manifested by thickening of capillary basement membrane and abnormal microcirculation, causing lesions in many organs such as kidney. In the kidneys, glomerulosclerosis can occur, affecting the filtration function of the glomerulus, and diabetic nephropathy occurs when kidney damage continues. Diabetic patients usually develop asymptomatic microalbuminuria after about 5-10 years of diabetes, and this phenomenon is the beginning of clinical diabetic nephropathy. Proteinuria is intermittent at first, but later becomes persistent and renal function gradually decreases. Patients will gradually notice an increase in frothy urine, swelling of the lower extremities, and the development of hypertension or original hypertension that is more difficult to control. Diabetic glomerulosclerosis can gradually develop renal failure after a long period of proteinuria. Once it occurs, the prognosis is very poor and patients will likely die from uremia. How to check and detect diabetic nephropathy early? The detection of microalbuminuria is very important for the screening of early diabetic nephropathy. The so-called “microalbuminuria” refers to the 24-hour urinary albumin excretion of 30-300mg, which is the early stage of clinical diabetic nephropathy. Once the 24-hour urine albumin excretion is above 300mg, it is the clinical proteinuria stage, when the kidney damage is often heavy and the development also enters an accelerated period, some patients appear a large amount of proteinuria, and the kidney function declines quickly. In addition to screening for proteinuria, regular measurement of glomerular filtration rate is also important for early detection of kidney damage. Of course, diabetic patients are often combined with other primary nephropathies, but they can be identified by combining some characteristics of diabetic nephropathy, which include: they are mostly associated with other damages such as retinopathy and peripheral neuropathy; hematuria is rare; proteinuria is still relatively high despite declining renal function; and renal volume changes and declining renal function do not parallel each other. In diabetic patients who have just started to develop microalbuminuria, active intervention is important to slow down the progression of diabetic nephropathy. Therefore, diabetic friends should pay attention to kidney health at an early stage and actively prevent and treat various complications, including nephropathy, from the day they are diagnosed with diabetes. We suggest that diabetic patients should visit the nephrology department regularly to dynamically monitor proteinuria and glomerular filtration function to protect kidney function as much as possible and prevent the occurrence of diabetic nephropathy; if diabetic nephropathy has been diagnosed, they should actively cooperate with the doctor for treatment to delay the progression of kidney failure. We wish all diabetic friends have a healthy pair.