Diabetic nephropathy patients with creatinine 230μmol/L, if diagnosed by a professional physician to exclude other diseases caused by renal hypoplasia, consider diabetic nephropathy stage V. Treatment includes intervention of various risk factors, low-salt, low-fat, high-quality protein diet, control of blood glucose, blood pressure, lipids and uric acid, correction of complications and renal replacement therapy for end-stage renal disease. Positive control of risk factors can help to slow down the progress of the disease, control blood glucose, control blood pressure, control of blood lipids, special attention should be paid to the patients with diabetic nephropathy due to renal function damage, the use of medication should be avoided nephrotoxic drugs, must be under the guidance of a professional physician to use medication for the complication of hypertension, atherosclerosis, cardio-cerebral vascular disease and other patients given to protect renal function treatment. Patients themselves need to cooperate with dietary treatment, to ensure sufficient calories at the same time, limit protein intake, low salt, less consumption of animal fat, more food rich in polyunsaturated fatty acids. At this time, diabetic patients are often combined with anemia, calcium and phosphorus disorders, acidosis, etc. At this time, we need to follow the doctor’s instructions to take oral iron polysaccharide, roxarestat, calcium acetate, lanthanum carbonate, sodium bicarbonate and other medications, to correct the complications and delay the progression of renal disease, for the combination of obvious pulmonary edema, pericardial effusion, patients with heart failure, can begin to carry out renal replacement therapy. The prognosis of diabetic nephropathy is not good, should be as early as possible regular hospitals to seek medical treatment, active treatment, do not be negligent, so as not to miss the condition.