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Kidney Disease Statistics in Maryland, USA

Kidney disease remains one of Maryland’s most significant and persistent public health challenges. Tens of thousands of Marylanders currently live with kidney failure, relying on either dialysis or a transplant to survive, and the number of people affected has continued to climb year after year. At the same time, the number of transplants performed in the state — especially those from living donors — has been shrinking, widening the gap between the need for transplants and the ability to provide them.

This article brings together statistics from multiple report years (2020–2026) covering kidney failure prevalence, dialysis, transplant waiting lists, transplants performed, the performance of Maryland’s kidney transplant centers, and the charitable financial assistance that many patients depend on. It also includes data on kidney and renal pelvis cancer incidence, mortality, and county-level variation across the state.

The data below is grouped by topic: kidney disease and failure, dialysis, cancer, kidney transplants, mortality trends, and financial assistance.

Chronic Kidney Disease (CKD) Prevalence Among Adults

3.9% of Maryland adults report ever being told by a health professional that they had kidney disease (excluding kidney stones, bladder infection, and incontinence)
Maryland ranks 23rd nationally on this measure

Nearly 4 in 100 Maryland adults report having been diagnosed with kidney disease, placing the state in the middle of national rankings (23rd).

At-Risk Population for Kidney Disease

2020 report: 12% diagnosed with diabetes; 32.4% have high blood pressure; 30.9% self-report as obese
2021 report: 11% diagnosed with diabetes; 34.3% have high blood pressure; 32.3% self-report as obese

Between the 2020 and 2021 reports, self-reported high blood pressure and obesity both rose (32.4%→34.3% and 30.9%→32.3%, respectively), while diagnosed diabetes edged down slightly (12%→11%). Since high blood pressure and diabetes are the two leading causes of kidney failure noted above, these risk-factor trends are directly relevant to the future burden of kidney disease in the state.

Kidney Failure and Treatment in Maryland

Prevalence Over Time

The number of Marylanders living with kidney failure, on dialysis, or living with a transplant has been tracked across several report years. The table below shows how these figures have evolved.

Report Year	Living with Kidney Failure	On Dialysis	Living with a Kidney Transplant
2020	16,531	11,200	5,331
2021	17,290	11,832	5,458
2023	17,739 (100%)	11,963 (67.4%)	5,776 (32.6%)
2024	17,784	11,916	5,868
2025	18,084	12,169	5,915
2026	18,497	12,393	6,104

The number of Marylanders living with kidney failure has risen steadily across every reporting period, growing from 16,531 in the 2020 report to 18,497 in the 2026 report — an increase of roughly 12% over that span. Dialysis remains the treatment for the large majority of patients (consistently around two-thirds of the ESRD population), while only about a third live with a transplant, underscoring the persistent gap between the need for transplants and the number of people who receive them.

Growth in Prevalence Since Earlier Decades

The data quantifies how much the ESRD population has grown compared to a decade earlier:

2023 report: 34.1% increase, compared to 2010
2024 report: 29% increase, compared to 2011
2025 report: 26% increase, compared to 2012
2026 report: 25% increase, compared to 2013

While the total number of people living with kidney failure keeps rising in absolute terms, the rate of growth compared to a decade earlier has been gradually slowing — from a 34.1% increase (2023 report) down to a 25% increase (2026 report). This suggests the disease burden, while still expanding, may be expanding somewhat less rapidly in relative terms than it did in the early 2010s.

Leading Causes of Kidney Failure

Diabetes and high blood pressure are identified as the two leading causes of kidney failure in Maryland.

Report Year	Diabetes	High Blood Pressure
2023	47%	30%
2024	44%	29%
2025	43%	30%

Diabetes and high blood pressure together account for roughly three-quarters of all kidney failure cases in Maryland across each reported year. Diabetes’ share has edged downward slightly across these three reports (from 47% to 43%), while high blood pressure’s share has stayed relatively flat (29–30%), indicating these two chronic conditions remain the dominant drivers of kidney failure in the state.

New Diagnoses and Initial Treatment Path

Each report also captures how many new cases of kidney failure were diagnosed in a given year, and whether the newly diagnosed patient received a transplant or began dialysis.

Diagnosis Year	New Cases Diagnosed	Received a Transplant	Began Dialysis
2017	2,488	78	2,488
2018	2,633	73	2,560
2020	2,555	75	2,480
2021	2,545	75	2,470
2022	2,696	89	2,607
2023	2,603	77	2,526

In every year for which data is available, the overwhelming majority of newly diagnosed kidney failure patients began dialysis rather than receiving a transplant. At best (2022 diagnosis year), only 89 of 2,696 new patients — about 3.3% — received a transplant as their initial treatment; in most years the share receiving a transplant was under 3%. This confirms that dialysis, not transplantation, is the default entry point into treatment for the vast majority of Marylanders newly diagnosed with kidney failure.

Kidney and Renal Pelvis Cancer in Maryland

Each year, more than 31,000 Marylanders are diagnosed with invasive cancer of any kind, and more than 10,000 Marylanders die from cancer.

Incidence

By Cancer Site: Maryland vs. U.S. (2018–2022)

Age-adjusted incidence rates per 100,000:

Cancer Site	Maryland Rate	U.S. Rate
Bladder	15.8	18.8
Brain & ONS	6.0	6.3
Breast (Female)	138.6	131.3
Breast (in situ) (Female)	31.7	29.8
Cervix (Female)	6.1	7.5
Colon & Rectum	35.1	36.7
Esophagus	3.9	4.6
Kidney & Renal Pelvis	15.6	17.5
Leukemia	13.0	14.3
Liver & Bile Duct	8.4	8.6
Lung & Bronchus	48.7	52.5
Melanoma of the Skin	25.0	23.1
Non-Hodgkin Lymphoma	17.3	18.5
Oral Cavity & Pharynx	10.9	12.1
Ovary (Female)	9.8	10.0
Pancreas	13.8	13.7
Prostate (Male)	142.1	116.4
Stomach	7.0	6.5
Thyroid	12.1	12.9
Uterus (Female)	28.0	27.9

Maryland’s kidney & renal pelvis cancer incidence rate (15.6 per 100,000) is below the national rate (17.5 per 100,000), one of several cancer sites — along with bladder, brain, cervix, colon & rectum, esophagus, leukemia, liver, lung, non-Hodgkin lymphoma, oral cavity, ovary, stomach (reversed), and thyroid — where Maryland runs below the U.S. average. By contrast, Maryland’s overall cancer rate, breast cancer, prostate cancer, and melanoma rates all run above the national average.

By County

Age-adjusted incidence rates (per 100,000) for a subset of Maryland counties, highest to lowest:

Dorchester: 25.0
Kent: 22.0
St. Mary’s: 21.1
Frederick: 17.4
Harford: 16.8
Talbot: 16.8
Washington: 16.5
Charles: 15.1
Prince George’s: 14.5
Somerset: 13.6
Wicomico: 13.5
Queen Anne’s: 13.4
Worcester: 13.1
Garrett: 12.4
Montgomery: 11.2
Howard: 11.1

Among the counties with data available, Dorchester County has by far the highest kidney & renal pelvis cancer incidence rate (25.0 per 100,000) — more than double the rate in Howard County, which has the lowest (11.1 per 100,000). Kent and St. Mary’s counties also stand out with notably elevated rates (22.0 and 21.1, respectively), while Montgomery and Howard counties, both largely urban/suburban, show the lowest rates in this list.

Late-Stage by County (2018–2022)

County	Rural-Urban Type	Age-Adjusted Incidence Rate (per 100,000)	Rate Rank	Avg. Annual Case Count	% of Cases Late Stage
Maryland (overall)	N/A	4.1	N/A	310	26.4%
U.S. (SEER+NPCR)	N/A	5.0	N/A	20,556	29.1%
Dorchester	Rural	7.4	1	4	31.7%
St. Mary’s	Urban	6.6	2	9	30.3%
Carroll	Urban	6.5	3	14	32.7%
Allegany	Rural	5.4	4	5	31.8%
Anne Arundel	Urban	4.9	5	34	31.0%
Cecil	Urban	4.8	6	7	26.8%
Wicomico	Urban	4.7	7	6	34.5%
Frederick	Urban	4.6	8	15	25.7%
Talbot	Rural	4.5	9	3	30.9%
Baltimore City	Urban	4.5	10	29	24.0%
Harford	Urban	4.4	11	15	26.1%
Baltimore County	Urban	4.0	12	46	24.2%
Calvert	Urban	3.9	13	4	25.9%
Washington	Urban	3.8	14	8	24.5%
Prince George’s	Urban	3.6	15	40	24.9%
Charles	Urban	3.5	16	7	22.4%
Howard	Urban	3.0	17	11	25.7%
Montgomery	Urban	2.9	18	38	25.7%

Maryland’s overall late-stage kidney & renal pelvis cancer incidence rate (4.1) and share of late-stage diagnoses (26.4%) are both below the U.S. rate (5.0 and 29.1%, respectively). Dorchester County — a rural county — again ranks highest for incidence (7.4), while Montgomery County has the lowest rate (2.9). Notably, Wicomico County has the highest share of cases diagnosed at a late stage (34.5%), even though its overall incidence rate is closer to the middle of the range, suggesting later detection there relative to case volume.

Mortality Trend (2000–2023)

During 2000–2023, kidney & renal pelvis cancer mortality in Maryland was falling, with an average annual percent change (APC) of -1.3% (95% CI: -1.7 to -0.8). Observed and estimated rates per 100,000 by year:

2000: Observed 4.0 / Estimated 4.1
2001: Observed 4.5 / Estimated 4.1
2002: Observed 3.9 / Estimated 4.0
2003: Observed 3.6 / Estimated 4.0
2004: Observed 3.8 / Estimated 3.9
2005: Observed 4.0 / Estimated 3.9
2006: Observed 3.5 / Estimated 3.8
2007: Observed 4.1 / Estimated 3.8
2008: Observed 3.7 / Estimated 3.7
2009: Observed 4.1 / Estimated 3.7
2010: Observed 3.8 / Estimated 3.6
2011: Observed 3.8 / Estimated 3.6
2012: Observed 3.2 / Estimated 3.5
2013: Observed 3.6 / Estimated 3.5
2014: Observed 3.2 / Estimated 3.5
2015: Observed 3.6 / Estimated 3.4
2016: Observed 3.2 / Estimated 3.4
2017: Observed 3.1 / Estimated 3.3
2018: Observed 3.4 / Estimated 3.3
2019: Observed 3.5 / Estimated 3.2
2020: Observed 3.3 / Estimated 3.2
2021: Observed 2.7 / Estimated 3.2
2022: Observed 3.2 / Estimated 3.1
2023: Observed 3.2 / Estimated 3.1

The estimated mortality rate for kidney & renal pelvis cancer in Maryland has declined steadily and consistently, from 4.1 per 100,000 in 2000 to 3.1 in 2023 — a decrease of roughly 24% over 23 years. Observed year-to-year rates fluctuate around this smooth downward trend line, with a low point in 2021 (2.7) and periodic higher spikes (e.g., 4.5 in 2001, 4.1 in 2007 and 2009), but the overall trajectory is a steady long-term decline.

Death Rates by County (2019–2023)

County	Rural-Urban Type	Age-Adjusted Death Rate (per 100,000)	Rank	Avg. Annual Deaths	Recent 5-Yr Trend
Maryland (overall)	N/A	3.2	N/A	242	Falling (-1.3)
United States	N/A	3.4	N/A	14,378	Falling (-1.4)
Howard	Urban	2.3	16	8	Falling (-24.9)
Montgomery	Urban	2.4	15	32	Falling (-1.8)
Frederick	Urban	2.7	14	9	Stable (-2.6)
Wicomico	Urban	2.7	13	3	Falling (-2.1)
Charles	Urban	2.8	12	5	Stable (-1.7)
Baltimore County	Urban	3.0	11	34	Falling (-1.8)
Prince George’s	Urban	3.1	10	33	Stable (-1.0)
Washington	Urban	3.4	9	8	Falling (-5.8)
Calvert	Urban	3.4	8	4	Data insufficient
Baltimore City	Urban	3.7	7	24	Stable (-0.6)
Allegany	Rural	3.8	6	4	Stable (-0.9)
Harford	Urban	3.8	5	13	Stable (-0.1)
Anne Arundel	Urban	3.9	4	27	Stable (-0.7)
Carroll	Urban	3.9	3	9	Stable (-0.4)
St. Mary’s	Urban	4.6	2	6	Stable (-1.0)
Cecil	Urban	5.5	1	7	Stable (0.8)

Maryland’s statewide kidney & renal pelvis cancer death rate (3.2 per 100,000) is slightly below the national rate (3.4). Cecil County has the highest death rate in the state (5.5) and is the only county showing a rising (though not statistically significant) 5-year trend (+0.8), while Howard County has both the lowest death rate (2.3) and the steepest declining trend of any county (-24.9). Most counties are classified as “stable” rather than clearly falling over the recent 5-year window, even though the statewide and national trends are both falling — suggesting county-level trends have wider uncertainty than the statewide figure.

Kidney Transplants in Maryland

Kidney Transplant Waiting List

The number of Marylanders waiting for a kidney transplant, and the rough odds of a waitlisted patient receiving a transplant, are shown below.

Report Year	Marylanders on the Kidney Transplant Waiting List	Odds a Waitlisted Patient Received a Transplant That Year
2020	2,431	About 1 in 6 (in 2019)
2021	2,116	About 1 in 5 (in 2020)
2023	1,789 (as of Feb. 17, 2023)	About 1 in 4 (in 2022)
2024	1,686	Not reported
2025	1,640	Not reported
2026	1,675	Not reported

The waiting list shrank considerably between the 2020 report (2,431 people) and the 2025 report (1,640 people), before ticking back up slightly to 1,675 in the 2026 report. Where reported, a waitlisted patient’s odds of actually receiving a transplant improved over time — from about 1 in 6 in 2019 to about 1 in 4 in 2022 — though even at the most recent reported rate, three out of four people on the waiting list did not receive a transplant that year.

Kidney Transplants Performed in Maryland

The table below shows the total number of kidney transplants performed in Maryland each year, broken down by living vs. deceased donor, along with the reported change compared to the same figure roughly a decade earlier.

Report Year	Transplant Year	Total Transplants	Total Transplants — Change vs. ~10 Yrs. Earlier	Living Donor Transplants	Living Donor — Change vs. ~10 Yrs. Earlier	Deceased Donor Transplants
2020	2019	437	Not reported	Not reported	Not reported	Not reported
2021	2020	389	Not reported	Not reported	Not reported	Not reported
2023	2022	414	21% decrease vs. 2012	93	50.5% decrease vs. 2012	321
2024	2023	406	21% decrease vs. 2013	81	Decrease vs. 2013 (figure not legible in source data)	325
2025	2024	371	27% decrease vs. 2014	74	56% decrease vs. 2014	297
2026	2025	364	32% decrease vs. 2015	80	53% decrease vs. 2015	284

The total number of kidney transplants performed annually in Maryland has trended downward, from 437 in 2019 to 364 in 2025 — a decline of about 17% over that period. Compared against each year a decade earlier, the gap has been widening: a 21% decrease was reported for both 2022 and 2023, growing to a 27% decrease for 2024 and a 32% decrease for 2025. Within these totals, deceased donor transplants consistently account for the large majority (roughly 78–81% of totals from 2022–2025), while living donor transplants make up a smaller and steadily shrinking share — down by roughly half or more compared to a decade earlier in every year where the comparison is available (50.5%–56% decreases). This shows transplant volume overall is falling further behind historical levels each year, driven in large part by the sustained, long-term drop in living donor kidney donation.

Kidney Transplant Centers in Maryland

Maryland has three kidney transplant centers: Johns Hopkins Hospital, University of Maryland Medical Center, and Walter Reed National Military Medical Center.

Donor-Related Program Participation

Rank

Center

NKR Transplants (Last 12 Mo.)

Deceased Donor Prioritization

Living Donor Prioritization

Donor Shield (NKR)

NKR Remote Donation

Voucher Program

NKR Member Center

Equal Access Commitment

Donor Referral Network

Kidney for Life

Donor Care Network

Nutcracker Care Network

Johns Hopkins Hospital

✅

❌

University of Maryland Medical Center

❌

Walter Reed National Military Medical Center

❌

Totals

Johns Hopkins Hospital accounts for all 10 of the National Kidney Registry (NKR) transplants recorded across Maryland centers in the last 12 months, and is the only Maryland center participating in any of the NKR donor-related programs listed (prioritization, Donor Shield, remote donation, voucher program, and NKR membership). Neither University of Maryland Medical Center nor Walter Reed participate in any of these NKR donor programs, based on this data.

Recipient-Related Program Participation

Rank	Center	Kidney for Life Participant	Low Eplet Transplants (12 Mo.)	NKR Transplants (12 Mo.)	NKR Living Donor Transplants (Prior Yr.)	Living Donor Transplants (Prior Yr.)	NKR % of Living Donor Transplants	Patient Microsites	Microsite Center of Excellence	Non-Steroidal Protocol	Voucher Program	NKR Member Center	Equal Access Commitment
1	Johns Hopkins Hospital	N	4	10	11	50	22%	N	N	N	Y	Y	N
2	University of Maryland Medical Center	N	0	0	0	31	0%	N	N	?	N	N	N
3	Walter Reed National Military Medical Center	N	0	0	0	16	0%	N	N	?	N	N	N
Totals	0	4	10	11	97	12%	0	0	0	1	1	0

Prior Year period: 04/01/2025–03/31/2026

Across the three Maryland centers, 97 living donor transplants were performed in the prior year, of which only 11 (12%) went through the NKR system — and all 11 of those NKR-affiliated living donor transplants occurred at Johns Hopkins Hospital. Johns Hopkins is also the only Maryland center with any low-eplet transplants (4) or voucher-program participation in this data set. Whether University of Maryland Medical Center and Walter Reed have a non-steroidal protocol is not indicated (“?”) in the data.

Transplant Outcomes

Adult

(LD = Living Donor, DD = Deceased Donor. Note: higher transplant volume in a category tends to correlate with a lower survival rate in that category, and centers that take on tougher cases are also likely to show lower survival rates.)

Center	NKR Transplants (Last 12 Mo.)	LD Transplants (Prior Yr.)	LD Graft 1-yr	LD Graft 3-yr	LD Patient 1-yr	LD Patient 3-yr	DD Graft 1-yr	DD Graft 3-yr	DD Patient 1-yr	DD Patient 3-yr
Johns Hopkins Hospital	10	50	99%	97%	99%	99%	95%	89%	99%	93%
University of Maryland Medical Center	0	31	99%	90%	100%	95%	88%	82%	93%	87%
Walter Reed National Military Medical Center	0	16	91%	94%	90%	97%	99%	88%	100%	98%

All three centers report strong one-year survival outcomes, generally 90% or higher across both living and deceased donor categories, for both graft and patient survival. Three-year outcomes show more variation: Johns Hopkins reports the highest 3-year deceased donor patient survival rate (93%), while the University of Maryland Medical Center reports the lowest 3-year deceased donor graft survival rate (82%). Walter Reed, despite having no NKR-tracked transplants in the last 12 months, reports the highest deceased donor 1-year graft (99%) and 1-year/3-year patient survival rates (100%/98%) among the three centers.

Pediatric

Rank	Center	NKR Transplants (12 Mo.)	Living Donor Transplants (Prior Yr.)	LD 1-Yr Graft	LD 3-Yr Graft	LD 1-Yr Patient	LD 3-Yr Patient	DD 1-Yr Graft	DD 3-Yr Graft	DD 1-Yr Patient	DD 3-Yr Patient
1	Johns Hopkins Hospital	10	50	100%	100%	100%	100%	86%	100%	100%	100%
2	University of Maryland Medical Center	0	31	100%	100%	100%	100%	100%	100%	100%	100%

(Walter Reed National Military Medical Center is not listed in the pediatric outcomes data.)

Pediatric outcomes at Johns Hopkins and University of Maryland Medical Center are exceptionally strong, with nearly every measured rate at 100%. The one exception is Johns Hopkins’ deceased-donor 1-year graft rate for pediatric patients, at 86% — notably lower than every other pediatric or adult outcome rate reported for either center.

Financial Assistance from the American Kidney Fund (AKF)

People living with kidney failure often need charitable financial assistance because kidney failure is a disability: dialysis functions as life support, and treating kidney failure along with its related health conditions is more time-consuming than a full-time job.

Grant Recipients and Charitable Assistance Provided

Assistance Year	Marylanders Receiving AKF Grants	Total Charitable Assistance
2019	1,848	$6 million
2020	2,052	$7.2 million
2022	1,805	$6,626,431
2023	1,758	$6,260,897
2024	1,830	$6,437,666
2025	2,003	Not specified

AKF assistance to Maryland dialysis and transplant patients has fluctuated between roughly 1,750 and 2,050 recipients per year across the reports, with total charitable assistance ranging from $6 million to $7.2 million. The number of recipients rose to 2,003 in the most recent (2026) report, the second-highest figure in the series, suggesting continued or growing need for this kind of support.

Insurance Coverage of AKF Grant Recipients

Among Marylanders who received AKF premium assistance, the data breaks down their insurance coverage type for three consecutive years.

Insurance Type	2022	2023	2024
Medicare Part B	40.9%	44.6%	25%
Medicare Advantage	1.3%	1.4%	0.6%
Medigap	27.2%	23.4%	27.3%
Commercial/Employer Group Plans (incl. COBRA)	17.7%	17.2%	20.1%

Medicare Part B was the single largest insurance category among AKF premium assistance recipients in the 2023 and 2024 reports (40.9% and 44.6%, respectively), but its share dropped sharply to 25% in the 2025 report, while Medigap and commercial/employer plans made up a larger relative share. Medicare Advantage represented only a small fraction of recipients in every year shown (0.6%–1.4%).

Medicare-Specific Statistics

Kidney Disease Among Maryland Medicare Beneficiaries

Medicare patients diagnosed with CKD: 3,795
Medicare patients on dialysis: 9,101
Medicare patients with a kidney transplant: 10,563
Medicare patients on the transplant waitlist: 2,840
Transplants performed (2016): 418
Medicare patients who died while on the waitlist (2016): 206

Average Cost to Medicare

Dialysis patient (annual): $85,979
Transplant, after first year: $32,586
Kidney disease test: $80–$143

Within the Medicare population alone, more patients were living with a transplant (10,563) than on dialysis (9,101), a different balance than seen in the overall Maryland kidney failure population where dialysis patients outnumber transplant recipients roughly two to one. The cost data highlights why transplantation is often favored where possible: after the first year, the average annual Medicare cost for a transplant recipient ($32,586) is less than half the cost of a dialysis patient ($85,979). The reported 206 Medicare patients who died while on the waitlist in 2016 — out of 2,840 on the list — illustrates the mortality risk of waiting for a transplant.

Disability, Minority Impact, and Financial Hardship

Kidney failure carries significant personal and financial burdens for patients, illustrated by the following statistics.

More than 80% of people on dialysis cannot work — kidney failure is considered a disability, and dialysis functions as life support, with treatment more time-consuming than a full-time job.
More than 60% of people affected by ESRD are minorities. Among patients AKF helps: 34.7% are Black, 20.9% are Hispanic/Latino, and 5.2% are Native American, Asian, or Pacific Islander.
Financial hardship is common: the average income of patients AKF helps is under $25,000, while average out-of-pocket costs for dialysis patients exceed $10,000 per year.

These figures show that kidney failure is not just a medical condition but a major disruption to patients’ ability to earn income, compounded by out-of-pocket costs that can equal 40% or more of a typical low-income patient’s annual earnings. The data also shows kidney failure disproportionately affects minority communities, consistent with the regional finding that nearly 80% of DC-area waitlisted patients are ethnic minorities.

Conclusion

The data compiled here shows a consistent and troubling pattern: the number of Marylanders living with kidney failure has grown every year across every report cycle, yet the number of kidney transplants performed in the state — particularly from living donors — has moved in the opposite direction, falling further behind a decade-old baseline with each new report. The transplant waiting list has come down somewhat in absolute numbers, but historically only a fraction of those on it, roughly one in five or six, have received a transplant in a given year, and transplant activity and program participation remain heavily concentrated at a single center, Johns Hopkins Hospital.

Behind these numbers is a patient population that carries a disproportionate burden in other ways as well. More than 80% of dialysis patients are unable to work, a large share are racial or ethnic minorities, and average incomes among those receiving charitable help are well below what is needed to cover the out-of-pocket costs of care. Programs like the American Kidney Fund’s grants, which have supported between roughly 1,750 and 2,050 Marylanders per year across the reports reviewed, help close some of this gap, but the underlying financial strain on patients remains substantial.

Finally, kidney and renal pelvis cancer presents a somewhat different picture: Maryland’s statewide incidence and mortality rates for this cancer are below the national average and have been declining steadily since 2000. Even so, meaningful variation exists across counties, with several rural and Eastern Shore counties — Dorchester, Cecil, and St. Mary’s among them — showing notably higher rates than the state as a whole. Together, these trends point to a kidney disease landscape in Maryland defined by growing need, constrained transplant supply, and uneven geographic and demographic impact.