Diabetic Nephropathy is a kidney complication of diabetes caused by prolonged high blood sugar and hypertension. It progresses from microalbuminuria to ESRD. Treatment includes glycemic control, ACE inhibitors, SGLT2 inhibitors, dialysis, or transplant. Emerging therapies offer hope. Diabetic Nephropathy is a kidney complication of diabetes caused by prolonged high blood sugar and hypertension. It progresses from microalbuminuria to ESRD. Treatment includes glycemic control, ACE inhibitors, SGLT2 inhibitors, dialysis, or transplant. Emerging therapies offer hope.