**1. Introduction**

The estimated worldwide prevalence of chronic kidney disease (CKD) in 2017 was 9.1%, an increase of 29.3% since 1990 [1]. In Japan, the number of patients with CKD is increasing annually, with one in eight adults estimated to have CKD. Under these circumstances, the medical economics of renal replacement therapy for patients with end-stage renal disease (ESRD) are attracting global attention against the backdrop of medical system sustainability. Based on these trends, this paper discusses the medical economics of renal replacement therapy by combining theories of medical value assessment and clinical economic studies. These findings are presumed to contribute to the further development of CKD treatment.
