Diabetic nephropathy is an important cause of endstage renal disease. Its incidence is closely correlated with the duration of diabetes mellitus. Hyperglycemia, hypertension, smoking, advanced age, insulin resistance, male gender, high protein intake, and genetic factors have been implicated in the development of diabetic nephropathy. It has been shown that non-enzymatic protein glycation, enhanced polyol pathway, increased protein kinase C activity, glucose toxicity, biochemical defects in the extracellular matrix, and genetic factors play role in its pathogenesis. Treatment of diabetic nephropathy includes good blood glucose regulation with insulin, treatment of hypertension and microalbuminuria with ACE inhibitors, and decreased protein intake.