Objective The purpose of this study was to analyze the clinical and pathological characteristics of type 2 diabetic patients with non⁃diabetic kidney disease（NDKD）and explore the predictors of the diagnosis of NDKD. Methods A retrospective cohort study was conducted to review the medical records of the patients with type 2 diabetes who underwent percutaneous renal biopsy in the First People′ s Hospital of Foshan from January 2017 to December 2021. Demographic data，clinical data，laboratory results and pathological examination results were collected. The patients were followed up until October 2022，with the renal prognostic events recorded. Multi⁃ variate logistic regression analysis was used to evaluate the predictors of NDKD. Results A total of 137 patients were included in this study，46 them with diabetic kidney disease（DKD），80 with NDKD，and 11 with DKD com⁃ plicated with NDKD. Among the pathological types，membranous nephropathy was the most common pathological type in the patients with NDKD and those with DKD complicated with NDKD，accounting for 46.25% and 54.55%， respectively. The NDKD group was better than the DKD in terms of renal prognosis. Multivariate analysis showed that the independent influencing factors included female（OR = 4.224，P = 0.027），age（OR = 1.094，P = 0.009）， duration of diabetes（OR = 0.841，P = 0.007），diabetic retinopathy（OR = 6.886，P = 0.036），systolic blood pressure （OR = 0.953，P = 0.005），glycated hemoglobin（OR = 0.632，P = 0.028），hemoglobin（OR = 1.045，P = 0.019） and blood phosphorus level（OR = 0.048，P = 0.019）. Conclusion Membranous nephropathy is the most common type of lesion in patients with NDKD. Such factors as female，older age，shorter duration of diabetes，absence of diabetic retinopathy，lower systolic blood pressure，lower glycosylated hemoglobin，higher hemoglobin level and lower blood phosphorus level are independent indicators for the diagnosis of NDKD.