The Renal Replacement Therapy ecosystem spans upstream suppliers of dialyzers, bloodlines, and concentrates, through midstream OEMs that integrate hardware, software, and disposables into hemodialysis (HD), peritoneal dialysis (PD), and continuous renal replacement therapy (CRRT) systems, to downstream channelsโhospital procurement groups, dialysis clinic chains, home-care agenciesโthat deliver therapy to end-stage renal disease (ESRD) patients. Value is created by securing biocompatibility, fluid precision, and regulatory compliance; it is captured by players who control reimbursement coding, service contracting, and data-driven remote monitoring platforms.