Chronic renal failure has various causes, but the most common causes are systemic diseases like diabetes and high blood pressure. National Health Insurance Service analyzed medical care expense payment data between 2009 and 2013 and announced the analysis results. The number of patients who made health insurance claims on account of ‘chronic renal failure (N18)’ increased by 13.6% a year on average from 90,596 in 2009 to 150,850 in 2013, whereas the number of patients who made health insurance claims due to ‘diabetes (E10~E14)’ also increased by 5.5% a year on average in the five-year period (2008-2012) from 1.79 million in 2008 to 2.21 million in 2012. More than 50% of all diabetic patients (as of 2012) received treatment for major complications, such as renal complications (diabetic kidney disease). For patients with underlying diseases like high blood pressure and diabetes, treatment and management of etiologic diseases is essential to prevent chronic renal failure, and even after the diagnosis of chronic renal failure, management of the above-mentioned underlying diseases, low-salt diet, avoidance of nephrotoxicity drugs and management of blood pressure and blood sugar is essential, and depending on the conditions of patients, scrupulous management of electrolyte imbalance, anemia and body fluid is also necessary. In 2013 in Kure, Hiroshima Prefecture, Japan, diabetes nurses conducted the self-management capability enhancement program to prevent intractable diabetic nephropathy for patients with stage 2 ~ stage 4 diabetic nephropathy as part of the medical cost reduction project. As a result, the city prevented more than 80% of new hemodialysis patients, and thus reduced medical expenses by about KRW50 million per patient. It is believe that this case will have positive implications for Korea.