The prevalence of diabetes is increasing year by year, and it is expected that by 2025, the number of people with diabetes in the world will reach 300 million, accounting for 5.4% of the world’s population. However, many diabetic patients, do you know that with diabetes, your kidneys may have been quietly injured. A survey found that 63.9% of type 2 diabetic patients have chronic kidney disease (CKD) damage, and diabetes is now recognized as one of the risk factors for chronic kidney disease (CKD). In fact, there is a long process from the time of elevated blood glucose to the time before serious kidney damage occurs. Diabetic patients go from the glomerular hyperfiltration phase through the microalbuminuria phase before finally manifesting as massive proteinuria and renal insufficiency. During this development process as long as the kidney damage can be detected early and reasonably protected, the process of diabetic nephropathy can be slowed down. Therefore it is crucial for diabetic patients to be alert for early detection and treatment of kidney injury. The more ideal indicators to screen diabetic patients for kidney injury are microalbuminuria and renal function tests. Generally speaking, annual screening for the presence of microalbuminuria and assessment of renal function should be started 5 years after the diagnosis of type 1 diabetes, and screening should be started immediately after the diagnosis of type 2 diabetes. Once diabetic nephropathy is diagnosed, interventional treatment should be carried out under the guidance of a specialist: first, maintain a good lifestyle: quit smoking, quit drinking, avoid the use of painkillers and other drugs that can easily cause kidney damage, and limit the intake of protein in the diet, with a recommended daily protein intake of 0.8-1g per kg of body weight and a diet based on high-quality protein, such as lean meat and fish. Secondly, high blood glucose is the root cause of kidney damage, controlling blood glucose not only helps to delay the occurrence of diabetic nephropathy, but also delays the progress of kidney damage, therefore, regardless of whether it is complicated by chronic kidney disease, glycosylated hemoglobin in diabetic patients should be controlled at 7.0%. Third, hypertension is also one of the causes of the progression of kidney injury, patients with early to mid-stage diabetic nephropathy should control their blood pressure to about 130/80mmHg as much as possible, and the first consideration in the choice of antihypertensive drugs should be ACEI and ARB class antihypertensive drugs. Because these drugs have been shown to significantly reduce urinary protein excretion and slow down the process of kidney disease. In fact, as long as there is no counter-indication, patients with diabetic nephropathy are recommended to apply ACEI/ARB drugs regardless of hypertension; in addition, effective drugs should be applied to improve the lipid profile, so that lipid control reaches the target value (LDL-C <700mg/L); finally, proteinuria status and renal function and progress should be monitored regularly, and once the presence of renal injury is diagnosed, it should be monitored at least every six months to one year. monitored at least once every six months to one year. Diabetic patients, your kidneys need more care from you, please don't let it hurt more. Diabetic nephropathy is a chronic renal complication of diabetes mellitus, which is characterized by high intra-glomerular pressure, hyperfiltration and hyperperfusion, followed by glomerular capillary collaterals, basement membrane thickening and increased thylakoid matrix, and finally glomerulosclerosis. The clinical manifestations are early microalbuminuria, followed by overt proteinuria, edema, hypertension or/and renal insufficiency. The disease has no significant regional differences and can be caused by diabetes mellitus type I and type II. Prevention of diabetic nephropathy: 1. Active control of hyperglycemia is a prerequisite for the prevention of diabetic nephropathy; 2. Control hypertension; 3. Limit protein intake; 4. Avoid nephrotoxic drugs and iodine contrast agents as much as possible; Some drugs are damaging to the kidneys and should be avoided as much as possible, such as: gentamicin. Iodine contrast agents can also aggravate the original renal damage, and diabetic patients should try to avoid intravenous renal montanogram. 5, dialysis should be early rather than late in renal failure.