OBJECTIVES: To collate published evidence evaluating economic implications of chronic renal disease (CRD) with and without co-morbid diabetes mellitus in China (post-2005). METHODS: A systematic search of electronic databases (Embase^® and MEDLINE^®) was conducted from January 2005 to March 2014 to identify economic studies in English evaluating CRD with and without co-morbid diabetes mellitus in China. RESULTS: Five studies (all cost of illness, CRD [n=3] and CRD with co-morbid diabetes [n=2]) of 134 citations retrieved, met pre-defined inclusion criteria. In 2012, total cost/patient for stage-3/4 CRD was Chinese Yuan (CYN) 34205 with 97.75% being direct cost, while for stage-5 CRD the corresponding values were CYN128231 and 82.3%, respectively (Wu 2013). In the study by Zhang and colleagues, patients undergoing haemodialysis (HD) incurred 16% higher costs relative to those undergoing peritoneal dialysis (PD) in 2010 (p=0.01). Further, patients with comorbid diabetes incurred higher total costs compared to their CRD alone counterparts (p=0.03) (Zhang 2012). Among patients with CRD in northwest China observed between March 2007 and February 2008, the first, second, and third year renal transplant (RT)/HD costs were CYN201674/CYN94136, CYN71746/CYN87765, and CYN66851/CYN86987, respectively indicating higher efficacy and lower costs of RT than HD from second year onwards (Xiaoming 2012). These findings were consistent with those reported in another study; in 2011 the direct cost of diabetes-associated renal failure with HD/PD was CYN72761.17/CYN470764.77 and RT was CYN218508.075 (Zheng 2012). Among diabetic patients with comorbid CRD, direct cost in 2007 was CYN1308.07 million, while corresponding cost projected in 2030 increased two-fold to CYN2351.60 million (Wang 2009). CONCLUSIONS: CRD consumes a large portion of healthcare expenditures (with direct medical cost being main cost driver) and is projected to exert heavy burden on health budget in future as well. Additionally, patients with comorbid diabetes incurred higher costs relative to their CRD alone counterparts.