Diabetic kidney disease is the most common cause of chronic kidney disease, leading to end-stage renal disease (ESRD) and premature death. In addition, it negatively affects a patient's quality of life and social environment, and poses a burden on national health care budgets. Although various therapeutic approaches, such as hypoglycemic agents, antihypertensive drugs, and renin-angiotensin system inhibitors, have been tried to slow the progression of nephropathy, the number of patients with diabetic kidney disease continues to rise with the prevalence of type 2 diabetes mellitus. Thus, early identification of patients at risk of developing diabetic nephropathy and initiation of appropriate therapy is important to improve patient outcomes. In end stage renal disease (ESRD), diabetic nephropathy is the main cause considered from other diseases.