Diabetic kidney disease (DKD) is a prevalent chronic condition, with metabolism and inflammation playing crucial roles in its pathogenesis. The uric acid to high-density lipoprotein cholesterol ratio (UHR) represents a novel index reflecting inflammatory and metabolic processes, yet its relationship with DKD remains to be elucidated. This study aimed to investigate the potential association between UHR and DKD.A cross-sectional analysis was conducted utilizing data from the National Health and Nutrition Examination Survey (NHANES, 2001-2018). Weighted multivariate logistic regression was employed to evaluate the association between UHR and DKD, while restricted cubic spline analysis was performed to detect the shape of the dose-response relationships between UHR and DKD. Subgroup analysis were performed to further examine the impact of additional covariates on the UHR-DKD relationship. The study comprised 7,138 patients with diabetes, of whom 2872 (40.24%) were diagnosed with DKD. An increase in the quartile range of UHR was associated with a progressive rise in DKD prevalence (30.51% vs. 32.75% vs. 35.59% vs. 46.72%, P < 0.001).After accounting for different confounding variables, a notable positive link was found between the UHR and DKD.When UHR was treated as a categorical variable, the quartile with the highest UHR showed a 573% increase in DKD prevalence compared to the quartile with the lowest UHR (OR 6.73, 95%CI [1.97, 23.05]). The restricted cubic spline revealed a positive linear correlation between UHR and DKD. Subgroup analyses and interaction tests revealed that age significantly influenced the UHR-DKD relationship (P < 0.05). The findings of this study suggest a significant correlation between UHR and DKD in the adult population of the United States. Nevertheless, further large-scale prospective studies are warranted to substantiate these results.