Objective  To investigate the effect of canagliflozin on body fat mass, glucose and lipid metabolism and kidney damage indexes in patients with type 2 diabetic nephropathy.Methods  A total of 100 patients with type 2 diabetic nephropathy who were admitted to The Fifth Affiliated Hospital of Xinjiang Medical University from March 2020 to June 2021 were retrospectively selected and divided into observation group (receiving canagliflozin + routine hypoglycemic treatment) and control group (receiving routine hypoglycemic treatment), with 50 cases in each group.The blood pressure, height, weight, body mass index (BMI), fasting blood glucose (FBG), glycosylated hemoglobin (HbAlc), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C) levels of the two groups before and after treatment were recorded. Urine microalbumin (mALB), urine a1 microglobulin (a1-MG), urine β2 microglobulin (β2-MG), urine N-acetyl-β-D-glucosaminidase (NAG), urine albumin/creatinine ratio (ACR) and 24-hour urine protein were detected, and adverse drug reactions were observed.Results  There were no statistically significant differences in all indicators between the two groups before treatment (all P>0.05). After treatment, the body weight and BMI of the observation group were lower than those before treatment, and the differences were statistically significant (all P<0.05). After treatment, the FPG and HbA1c of the two groups were lower than those before treatment, and the differences were statistically significant (all P<0.05). After treatment, the FPG and HbA1c of the observation group were lower than those of the control group, but the differences were not statistically significant (all P>0.05). There was no significant difference in TC, TG, LDL-C and HDL-C between the two groups before and after treatment (all P>0.05). There were statistically significant differences in UA, mALB, ACR and 24-hour urine protein in the observation group after treatment compared with those before treatment (all P<0.05). After treatment, the ACR of the control group was lower than that before treatment, and the difference was statistically significant (P<0.05). After treatment, the UA, mALB, ACR and urine protein in the observation group were lower than that in the control group (all P<0.05). There was no statistically significant difference in adverse drug reactions between the two groups (4.00% vs. 2.00%, P>0.05).Conclusions  Canagliflozin can effectively reduce blood sugar, reduce the body weight of patients with diabetic nephropathy, and at the same time reduce the excretion of urine protein, has good renal protection, and has good safety.It is worthy of further clinical promotion.