Objective To investigate the impact of blood glucose on complications and survival rate in diabetic nephropathy on maintenance hemodialysis. Methods Fifty-five cases of diabetic nephropathy on maintenance hemodialysis treated in this hospital in the period of 1999 to 2004 were retrospectively surveyed. Patients were categorized into three groups based on their fasting blood glucose level: group A, <6.1mmol/l; group B, >6.1 mmol/l and <7.0mmol/l; group C, =7.0mmol/l. Cardiovascular and cerebrovascular diseases, severe infections, hypoglycemia and blood biochemistry were monitored. Survival rate were calculated after dialysis for one and three years. Results The incidence rate of cardiovascular diseases, severe infections, anemia and hypoproteinemia was higher in groups A and C than in group B (P <0.05). The one year and three year survival rates were higher in group B, but they had no statistical significance among the three groups (P>0.05). Conclusion For the reduction of complications, the fasting blood glucose should be controlled to the range of 6.1-7.0mmol/l in diabetic nephropathy on maintenance hemodialysis.