Objective To study the effect of individualized guidance in hemodialysis patients with diabetes nephropa-thy.Methods A total of 76 patients with diabetic nephropathy admitted to Taizhou Second People's Hospital from January 2020 to June 2024 were selected and divided into observation group and reference group with 38 cases in each group according to different nursing methods.Routine nursing and hemodialysis nursing with individualized guid-ance were respectively given to compare blood glucose levels,nursing satisfaction and complications between the two groups.Results After nursing,the levels of fasting plasma glucose and glycated hemoglobin A1c in the observation group were lower than those in the reference group,and the differences were statistically significant(both P<0.05).The nursing satisfaction of patients in observation group was higher than that in reference group,and the difference was statistically significant(P<0.05).The incidence of complications in observation group was lower than that in refer-ence group,and the difference was statistically significant(P<0.05).Conclusion Hemodialysis nursing combined with individualized guidance has significant effect on the maintenance of autologous arteriovenous fistula in patients with diabetic nephropathy on dialysis.The patients have higher satisfaction with nursing and lower complication rate.