Abstract：Based on the five viscera as a principle and the deficiency syndrome of the five viscera，the authors reviewed the understanding and research results of modern physicians on the pathogenesis of diabetic nephropathy. It was summarized that the basic pathogenesis of diabetic nephropathy was deficiency and depletion of the five viscera； the key of the pathogenesis was deficiency and depletion of the five viscera as well as excess pathogen；the core of the pathogenesis for the staging of diabetic nephropathy is the deficiency syndrome of the five viscera. This paper aimed to explore effective methods of Chinese medicine for the treatment of diabetic nephropathy from the understanding of the pathogenesis and to expand ideas for improving clinical efficacy.