Diabetes is the most common cause of end-stage renal disease; however, there is evidence that diabetes-related renal disease can be prevented with interventions currently available. The purposes of this article are to describe current screening and intervention guidelines for renal complications in patients with diabetes and to provide clinical nurse specialists with tools to facilitate the education and expert guidance needed by patients with diabetes to preserve their kidney function. This article includes (1) a review of the pathology of diabetic nephropathy, (2) a summary of screening guidelines, (3) current treatment recommendations to prevent or delay nephropathy, and (3) nursing strategies and tools framed within the education, expert coaching, and guidance roles of the clinical nurse specialist practice model.