Abstract: OBJECTIVE To explore the association between the susceptibility to pulmonary infection in diabetic nephropathy（DN） patients undergoing hemodialysis with polymorphisms of interleukin-10（IL-10） and surfactant protein D（SP-D） genes. METHODS A total of 109 DN patients who underwent hemodialysis in the Fifth Affiliated Hospital of Xinjiang Medical University from May 2018 to Mar 2021 were enrolled in the study, 53 of whom were complicated with pulmonary infection and assigned as the infection group, 56 were not complicated with pulmonary infection and assigned as the no infection group. The genotypes of IL-10 and SP-D were detected, the frequencies of genotypes were compared between the infection group and the no infection group. Logistic regression analysis was performed for the correlation between the single nucleotide polymorphisms of IL-10 and SP-D and the pulmonary infection in the DN patients. RESULTS Totally 63 positive strains were isolated from 53 patients of the infection group, 43（68.25%） of which were gram-negative bacteria. The proportions of patients with no less than 60 years of age and serum albumin level less than 35 g/L were higher in the infection group than in the no infection group（P＜0.05）. The frequencies of AA genotype and A allele at IL-10-rs1800896 locus were lower in the infection group than in the no infection group, while the frequencies of CC genotype and C allele at SP-D-rs721917 locus were higher in the infection group than in the no infection group（P＜0.05）. The result of logistic regression analysis showed that the no less than 60 years of age and CC genotype at SP-D-rs721917 locus were the risk factors for pulmonary infection in the DN patients undergoing hemodialysis; the serum albumin level and AA genotype at IL-10-rs1800896 locus were the protective factors for pulmonary infection in the DN patients undergoing hemodialysis（P＜0.05）. In the infection group, the serum IL-10 level of the patients with AA genotype at IL-10-rs1800896 locus was higher than that of the patients with GG or AG genotype, while the serum SP-D level of the patients with CC genotype at SP-D-rs721917 locus was lower than that of the patients with CT or TT genotype（P＜0.05）. CONCLUSION The advanced age and low level of serum albumin may increase the risk of pulmonary infection in the DN patients undergoing hemodialysis, the gram-negative bacteria are dominant among the pathogens. The AA genotype at IL-10-rs1800896 locus is a protective genotype for pulmonary infection, and the CC genotype at SP-D-rs721917 locus is a risk genotype for pulmonary infection.