Background: Diabetic kidney disease (DKD) occurs in 25% to 40% of patients with diabetes mellitus (DM) and is the leading cause of kidney failure worldwide. Aim of the work: To evaluate the association between proteinuria and degree of thyroid dysfunction in type II diabetes patients with and without diabetic nephropathy. Patients and Methods: This prospective cross-sectional study was conducted on 104 patients with type II diabetes mellitus. Patients were allocated into 2 groups; group I (52 patients) included diabetic patients with diabetic kidney disease and group II (52 patients) included diabetic patients without diabetic kidney disease. All studied cases were subjected history taking, thorough clinical examination and laboratory investigations. Results: TSH had the highest mean values among hyperfiltration group with statistically significant difference (p< 0.001). T3 had the lowest mean values among hyperfiltration group with statistically significant difference (p= 0.002). All hyperfiltration groups were hypothyroidism, 93% of hypofiltration were hypothyroidism and 78.1% of normal filtration were hypothyroidism showing presence of statistically significant difference as regard thyroid status (p= 0.04). Conclusion: Hypothyroidism and diabetic kidney disease exhibit a bidirectional association, where each condition may exacerbate the progression of the other. This complex interplay significantly correlates with changes in proteinuria and estimated glomerular filtration rate, emphasizing the need for integrated management strategies in these patients.