BACKGROUND  Clinical studies have shown that treatment of chronic kidney disease patients at predialysis stage (predialysis) with a low protein diet (LPD) and ketoanalogues of essential aminoacids (ketoanalogues) provides clinical and economic benefits. Then, it’s actual to define pharmacoeconomic effects of using LPD and ketoanalogues in predialysis patients in Russian Federation (RF). OBJECTIVES: To provide pharmacoeconomic assessment of LPD and ketoanalogues supply of predialysis patients in RF. METHODS: Decision tree modelling approach, cost-utility (CUA) and budget impact analyses (BIA) were performed. Direct costs (ketoanalogues, erythropoietin, hemodialysis, peritoneal dialysis, etc.) were considered. Two patients groups were compared in the model: ketoanalogues and LPD was administrated for the first arm in predialysis stage, while second arm started in the model of dialysis patients. Results of retrospective efficacy analysis state, that administration of keto-analogues and LPD delays start of dialysis at least for one year. State utility approach was used for cost-utility analysis. Time horizon of the model was up to 5 years. NHS prices and Sechenov University hospitals price lists were used. RESULTS: The first year annual costs were $38511 per patient for the patients group on dialysis and $13763 for the group of ketoanalogues. The results of BIA have shown, that total cost-saving per patient in the group of ketoanalogues and LPD over 5-year period was $21812 compared with the dialysis group. Cost-utility ratio (CUR) for the ketoanalogues and LPD group varies from $15316 per QALY for the first year to $34673 per QALY over five years, while in the dialysis group CUR ranged from $50051 per QALY in the first year to $45819 per QALY over five years. CONCLUSIONS: CUA have shown that treatment of predialysis patients with ketoanalogues and LPD in RF is a preferable technology and provides cost-saving of $21812 over five years per patient.