The article summarizes recent data on the role of interleukin-6 (IL-6) in the development of diabetic nephropathy (DN) and related pathological conditions. The effects determined by the activation of membrane (IL-6R) and soluble (sIL-6R) receptors are described. Clinical and experimental studies of the IL-6 interconnections with obesity, insulin resistance, renal fibrosis, cardiomyopathy and anemia are analyzed. The strategies of anti-inflammatory therapy and nephroprotection are discussed.