The treatment of diabetic nephropathy with blood creatinine 200μmol/L mainly includes dietary treatment, blood sugar control, blood pressure control, blood lipid regulation, complication treatment, dialysis and transplantation. 1. Dietary treatment: high-quality low-protein diet, giving protein 0.6g/(kg.d); in order to prevent the occurrence of malnutrition, it should be ensured to give enough calories. 2. Blood sugar control: glycated hemoglobin should be controlled at about 7% in patients with diabetic nephropathy. Due to the abnormal renal function of patients, use sulfonylurea and bisphosphonate drugs cautiously, and choose the drugs less excreted by kidney, such as acarbose, pioglitazone and so on. If necessary, insulin hypoglycemic therapy can be used. 3. Control blood pressure: ACEI/ARB drugs such as captopril and irbesartan are preferred, but patients should be closely observed for renal function and potassium. 4. Regulate blood lipids: for those with increased serum cholesterol, statin lipid-lowering drugs such as atorvastatin are preferred; for those with increased triglycerides, fibric acid derivatives such as fenofibrate are preferred. At the same time, eat less animal fat. 5. Treatment of complications: patients with hypertension, atherosclerosis, cardiovascular and cerebrovascular diseases, other microvascular diseases, etc. should be treated accordingly to protect renal function. Avoid using nephrotoxic drugs as much as possible. 6. Dialysis and transplantation: If patients have heart failure which is not easy to be controlled, serious gastrointestinal symptoms, etc., dialysis or kidney transplantation can be used. If patients with diabetic nephropathy have elevated creatinine, it is recommended that they go to regular hospitals in time and receive standardized treatment under the guidance of doctors.