Aims: To explore whether an integrated nephrology-diabetology (NPD) approach, can improve adherence to management guidelines for patients with diabetic kidney disease (DKD). Methods: In this cross-sectional retrospective analysis, 110 DKD patients attending the NPD outpatient service of CTO Hospital (Rome) were included (aged 71.1±10.1 years; 74.5% males; 98.2% with type 2 diabetes). Patterns of anti-diabetic and other medications prescription were compared before and after attending the NPD service. Results: The study population was divided in subgroups: ‘ALB’ (only with UACR >30 mg/gr) (28.2%); ‘CKD’ (only with eGFR<60 ml/min) (33.6%); CKD + ALB (eGFR<60 ml/min and UACR >30 mg/gr) (38.2%). Between subgroups only age (p<0.01) and urea (p<0.01) showed statistically significant differences. Prescription rates of SGLT2-i (p<0.01), GLP1-RA (p=0.02), association of SGLT2-i and GLP1-RA (p=0.01), statins (p<0.01), calcium channel blockers (p=0.01), urate lowering therapy (p<0.01), and folic acid (p<0.03) significantly differed between pre- and post-NPD service attendance. Conclusions: attendance to an outpatient service with integrated diabetology and nephrology skills increased prescriptions of drugs – such as SGLT2-is and GLP1-RAs – with proven reno-protective effects. This integrated approach is likely to improve adherence to DKD management guidelines, leading in the end to a more comprehensive strategy of cardiovascular risk reduction.