Objective To explore the effect of betaine-containing methyl nutrients on renal function and urinary microalbuminuria MA in patients with diabetic kidney disease DKD accompanied by hyperhomocysteinemia HHcy . Method Sixty-four patients with DKD and HHcy were recruited from Shenzhen Traditional Chinese Medicine Hospital between September 2019 to January 2021. They were randomly divided into methyl nutrient group n = 21 and folate methylcobalamin group n = 32 . After 16 weeks of intervention the differences in blood glucose blood lipids renal function and MA and other indicators between the two groups were studied. The treatment effect was represented by intention-to-treat analysis. Result Compared with the folate methylcobalamin group urea nitrogen UN serum creatinine Scr uric acid UA cystatin C Cys C homocysteine Hcy urine creatinine UCr MA β2 microglobulin Uβ2 -MG N- acetylglucosaminidase NAG total urinary protein TP -U and urinary albumin / creatinine ratio ACR were significantly decreased in methyl nutrient group containing betaine. The increase of estimated glomerular filtration rate eGFR and folic acid FA in estimated glomerular filtration rate in the methyl nutrient group containing betaine were better than the folate methylcobalamin group with significantly significant differences. Conclusion HHcy may be one of the factors affecting the renal function of patients with T2DM. The reasonable application of betaine-containing methyl nutrients can reduce Hcy levels effectively protect renal function and reduce MA levels.