Rheumatic autoimmune diseases often lead to kidney injury, presenting diverse manifestation and complex conditions, ranging from mild proteinuria to severe glomerulonephritis and even renal failure, which has significant impact on patient’s prognosis and quality of life. Because renal damage often has an insidious onset, early diagnosis and intervention are crucial, and development of non-invasive biomarkers is urgently needed. The pathological mechanisms of the disease often involve multiple system; multidisciplinary collaboration including rheumatologists and nephrologists is crucial. The continuous development of biomarkers has made earlier detection and intervention of the disease, bringing new hope for improving patient prognosis. This article discusses the pathogenesis, diagnosis and treatment strategies of renal damage associated with rheumatic autoimmune diseases, emphasizes the importance of multidisciplinary collaboration in disease management. Through precise immunotherapy, appropriate drug adjustments, and kidney protection strategies, the disease can be effectively controlled, and kidney damage can be alleviated and the quality of life of patients will be improved in the future.