Objective To investigate the awareness of knowledge of diabetic kidney disease (DKD) and related factors in six provinces in China. Methods From December 2021 to March 2022, a cross‑sectional survey study using a structured questionnaire was conducted among 6 230 type 2 diabetes (T2DM) patients aged 18 years and above in six provinces in China (Heilongjiang Province, Hubei Province, Guangdong Province, Gansu Province, Tianjin City, and Chongqing City). The survey collected information on the patients′ general characteristics (gender, education level, region, residential area, and duration of diabetes), awareness of DKD prevention and treatment knowledge (including common symptoms of kidney disease, DKD risk factors, and DKD prevention and control measures), and self‑assessment of DKD knowledge and skills. The Chi‑square test was used for inter‑group comparisons. Results Only 18.15% (1 131/6 230) of patients were aware of anemia and fatigue as common symptoms of kidney disease, while 36.84% (2 295/6 230) had no knowledge of any common symptoms of kidney disease. In terms of awareness of DKD risk factors, only 17.61% (1 097/6 230), 16.95% (1 056/6 230), and 13.34% (831/6 230) of the respondents were aware of acute kidney injury, nephrotoxic substances, and excessive protein intake, respectively, while 32.81% (2 044/6 230) had no knowledge of any DKD risk factors. Regarding knowledge of DKD prevention and control measures, only 44.96% (2 801/6 230), 37.37% (2 328/6 230), 33.87% (2 110/6 230), and 25.81% (1 608/6 230) of patients were aware of medication adherence, regular follow‑up and monitoring, blood pressure control, and lipid control, respectively, while 20.13% (1 254/6 230) had no knowledge of any DKD prevention and control measures. Comparison of the knowledge of DKD prevention and treatment among different groups showed that male patients, those from the northern regions, those with a higher level of education, and those with diabetes mellitus for 10 years or more had higher awareness rates of common symptoms, risk factors, and prevention and control measures for DKD (P<0.05). Compared with rural residents, urban residents had higher awareness rates of common symptoms and risk factors of kidney disease (P<0.01). Conclusions The awareness levels of common symptoms of kidney disease, DKD risk factors, and prevention and control measures among diabetes patients in six provinces in China are relatively low, and there are significant differences in awareness levels among diabetes patients of different genders, residential areas, regions, education levels, and disease courses. [ABSTRACT FROM AUTHOR]