Abstract： By summarizing the understanding of Chinese medicine on the pathogenesis of diabetic nephropathy， it is believed that it mainly focuses on the deficiency in origin， excess in superficiality， pathogenic route and other aspects at present. Among them，deficiency in origin is the essential basis for the occurrence of diabetic nephropathy，which can be discussed from the perspectives of qi，blood，body fluids，essence，zang-fu organs，and yin-yang. Excess in superficiality is both the result and cause of diabetic nephropathy， which can be discussed from the aspects of dampness， turbidity， phlegm， stasis， toxin， wind， and latent pathogens. Pathogenic route can be discussed from collaterals and from sweat pore. Other aspects can be discussed from six- meridian theory. This paper can provide in- depth thinking and directional guidance for prescription selection，and play a relatively accurate and rapid role in improving clinical effect.