Over the past two decades, diabetic kidney disease (DKD) has remained the leading cause of end‑stage kidney disease (ESKD) worldwide [1]. In type 1 diabetes (T1D), the incidence of ESKD has progressively declined due to improved glycemic control, early screening, and renin–angiotensin system blockade [2]. In contrast, the global burden of ESKD in type 2 diabetes (T2D) has increased, driven by population aging, obesity, metabolic syndrome, and delayed diagnosis [3]. The therapeutic landscape has been reshaped by SGLT2 inhibitors, GLP‑1 receptor agonists, and finerenone, which have demonstrated significant renal protection [4-6]. This review summarizes epidemiological trends, pathophysiology, risk factors, and therapeutic advances in DKD from 2004 to 2024.