Kidney disease in Massachusetts spans a wide spectrum — from chronic kidney disease (CKD) in the general population, to kidney failure (end-stage renal disease, or ESRD) requiring dialysis or transplant, to kidney and renal pelvis cancer. Each of these conditions carries its own patterns of prevalence, risk, and outcome across the state.
This article brings together statistics on CKD and ESRD prevalence, kidney disease mortality, transplant center activity and outcomes, and the financial and insurance burden carried by patients — followed by a dedicated look at kidney cancer incidence and mortality, which is a distinct condition from kidney failure.
Some statistics appear side by side as snapshots from different points in time. Presented together, they offer the fullest picture available of how kidney disease affects Massachusetts residents.
Chronic Kidney Disease (CKD) in Massachusetts
Two different measures of CKD prevalence are available: a local estimate for the city of Holyoke, and a statewide self-reported figure with its national ranking.
- Holyoke, MA: 38.2% of adults have chronic kidney disease
- Massachusetts (statewide comparison): 34.3% of adults have chronic kidney disease
- Massachusetts (statewide, self-reported): 3.8% of adults say they were ever told by a health professional they had kidney disease (excluding kidney stones, bladder infection, or incontinence) — ranking 19th nationally
Holyoke’s estimated CKD rate (38.2%) runs notably above the statewide comparison figure (34.3%), suggesting the city carries a heavier-than-average kidney disease burden. The much lower 3.8% figure reflects a different, narrower measure — self-reported diagnosis by a health professional — and the two statistics likely come from different survey methodologies, so they should not be compared directly.
Kidney Failure (End-Stage Renal Disease) in Massachusetts
Burden of Kidney Failure Over Time
The data includes three separate fact sheets — each reporting on a different reference year. Combined, they show how the kidney failure population, dialysis dependency, and transplant activity have evolved.
| Metric | 2021 Report (data through 2020) | 2023 Report (data through 2022) | 2025 Report (data through 2024) |
| MA residents living with kidney failure | 12,754 | 12,764 | 12,907 |
| — on dialysis | 7,646 | 7,511 (58.8%) | 7,357 |
| — living with a transplant | 5,108 | 5,253 (41.2%) | 5,550 |
| Increase in kidney failure population | — | +28.9% since 2010 | +22% since 2012 |
| New kidney failure cases diagnosed | 1,986 (2018) | 1,774 (2020) | 1,838 (2022) |
| — of those, received a transplant | 104 | 66 | 104 |
| — of those, began dialysis | 1,882 | 1,708 | 1,734 |
| Residents on kidney transplant waiting list | 3,361 | 3,628 | 3,370 |
| Chance of receiving a transplant off the waiting list | ~1 in 8 (2020) | ~1 in 6 (2022) | ~1 in 5 (2024) |
| Kidney transplants performed in MA | 434 (2020) | 617 (2022) — 61.1% increase vs. 2012 | 722 (2024) — 56% increase vs. 2014 |
| — living donor transplants | n/a | 165 — 1.8% decrease vs. 2012 | 206 — 7% increase vs. 2014 |
| — deceased donor transplants | n/a | 452 | 516 |
The number of Bay Staters living with kidney failure has been climbing steadily — up nearly 23–29% over the prior decade depending on the report cited. Encouragingly, total transplant volume in Massachusetts has grown substantially (56–61% increases versus a decade earlier), and deceased donor transplants now significantly outnumber living donor transplants.
Risk Factors for Kidney Failure
- Diagnosed diabetes: 8.4% of MA adults
- High blood pressure (self-report): 28.1% of MA adults
- Obesity (self-report): 25.2% of MA adults
High blood pressure and obesity are far more prevalent than diagnosed diabetes among Massachusetts adults, and both are established drivers of kidney damage. Roughly one in four to one in three residents carries at least one of these risk factors, underscoring why kidney failure cases continue to rise statewide.
Leading Causes of Kidney Failure
| Cause | 2023 | 2025 |
| Diabetes | 47% | 43% |
| High blood pressure | 30% | 30% |
Diabetes and high blood pressure together account for roughly three-quarters of all kidney failure cases in Massachusetts, with diabetes consistently the single largest cause.
Kidney Cancer (Kidney & Renal Pelvis) Statistics
This section covers kidney and renal pelvis cancer specifically — a distinct condition with its own incidence.
Incidence by County (Female, Late Stage)
Data covers 2018–2022, female patients only.
| Geography | Age-Adjusted Incidence Rate (per 100,000) | CI Rank | Avg. Annual Cases | % Diagnosed at Late Stage |
| Massachusetts | 2.9 (2.7–3.2) | N/A | 140 | 29.9% |
| US (SEER+NPCR) | 3.1 (3.1–3.1) | N/A | 6,720 | 26.4% |
| Hampden County | 3.9 (3.0–5.2) | 1 (1–6) | 12 | 29.3% |
| Norfolk County | 3.6 (2.8–4.4) | 2 (1–7) | 18 | 34.9% |
| Worcester County | 3.5 (2.8–4.2) | 3 (1–7) | 20 | 34.0% |
| Plymouth County | 3.2 (2.5–4.2) | 4 (1–9) | 13 | 29.3% |
| Suffolk County | 2.8 (2.1–3.7) | 5 (2–9) | 12 | 27.4% |
| Bristol County | 2.8 (2.1–3.7) | 6 (2–9) | 11 | 27.1% |
| Essex County | 2.8 (2.2–3.5) | 7 (2–9) | 16 | 28.4% |
| Barnstable County | 2.7 (1.9–3.9) | 8 (2–9) | 8 | 31.0% |
| Middlesex County | 2.3 (1.9–2.8) | 9 (5–9) | 24 | 27.6% |
Note: Hampshire, Berkshire, Franklin, Dukes, and Nantucket counties are not included, likely due to insufficient case counts.
Among Massachusetts women, kidney cancer incidence (2.9 per 100,000) runs slightly below the national rate (3.1), but a higher share of Massachusetts cases are caught at a late stage (29.9% vs. 26.4% nationally) — a potential concern for early detection. Hampden County again tops the list for incidence. Norfolk and Worcester counties stand out for having the highest proportions of late-stage diagnoses (34.9% and 34.0%, respectively), even though their overall incidence rates are mid-range.
Incidence — State Comparison (Female, All Stages)
Data covers 2018–2022, female patients only.
| State/Area | Age-Adjusted Incidence Rate (per 100,000) | CI Rank | Avg. Annual Cases | Trend | 5-Yr Trend |
| US (SEER+NPCR) | 12.1 (12.0–12.2) | N/A | 25,468 | Falling | -0.9 (-2.0, -0.2) |
| Oklahoma | 16.5 (15.8–17.3) | 1 (1–6) | 393 | Stable | -1.8 (-5.1, 1.4) |
| Louisiana | 16.3 (15.6–17.0) | 2 (1–6) | 474 | Stable | 0.3 (-0.5, 0.9) |
| West Virginia | 16.2 (15.2–17.3) | 3 (1–10) | 200 | Rising | 2.6 (1.7, 3.5) |
| Arkansas | 16.1 (15.3–16.9) | 4 (1–8) | 307 | Stable | -3.1 (-7.4, 2.1) |
| Mississippi | 15.8 (15.0–16.7) | 5 (1–9) | 302 | Stable | -1.0 (-5.2, 1.6) |
| Kentucky | 15.1 (14.4–15.7) | 6 (3–12) | 435 | Stable | 0.7 (-1.1, 1.6) |
| Texas | 15.0 (14.7–15.2) | 7 (5–10) | 2,380 | Rising | 1.1 (0.6, 1.3) |
| Missouri | 14.8 (14.3–15.4) | 8 (4–12) | 594 | Rising | 1.6 (1.1, 2.2) |
| Iowa | 14.4 (13.6–15.2) | 9 (5–16) | 291 | Stable | 1.4 (-1.0, 2.0) |
| Nebraska | 14.1 (13.1–15.1) | 10 (5–21) | 165 | Rising | 1.7 (0.6, 2.8) |
| South Dakota | 14.0 (12.5–15.6) | 11 (2–29) | 75 | Rising | 1.8 (0.4, 3.4) |
| Tennessee | 13.9 (13.4–14.5) | 12 (8–17) | 619 | Stable | -3.6 (-7.9, 0.9) |
| Indiana | 13.8 (13.3–14.3) | 13 (9–18) | 581 | Rising | 0.7 (0.2, 1.2) |
| Kansas | 13.7 (12.9–14.6) | 14 (7–22) | 242 | Stable | 0.8 (-0.7, 1.7) |
| North Dakota | 13.4 (11.8–15.1) | 15 (4–38) | 60 | Rising | 1.3 (0.2, 2.5) |
| Alabama | 13.2 (12.6–13.8) | 16 (10–24) | 441 | Stable | 1.6 (-0.1, 2.1) |
| Ohio | 13.0 (12.7–13.4) | 17 (13–23) | 1,011 | Stable | 0.7 (-0.1, 1.0) |
| North Carolina | 13.0 (12.6–13.4) | 18 (13–24) | 891 | Stable | 0.9 (-0.7, 1.4) |
| South Carolina | 12.5 (12.0–13.1) | 19 (14–30) | 440 | Rising | 1.3 (0.7, 1.9) |
| Georgia | 12.5 (12.1–12.9) | 20 (16–28) | 811 | Rising | 1.7 (1.3, 2.2) |
| Illinois | 12.5 (12.2–12.9) | 21 (16–28) | 1,021 | Stable | 0.0 (-0.4, 0.4) |
| Wisconsin | 12.5 (12.0–13.0) | 22 (15–30) | 484 | Rising | 1.1 (0.3, 2.0) |
| Delaware | 12.4 (11.2–13.7) | 23 (10–43) | 86 | Stable | 0.9 (-0.5, 2.3) |
| New Mexico | 12.2 (11.3–13.1) | 24 (14–39) | 162 | Rising | 2.0 (1.7, 2.4) |
| Alaska | 12.1 (10.5–13.8) | 25 (8–49) | 46 | Falling | -11.1 (-18.8, -0.8) |
| Minnesota | 11.9 (11.4–12.5) | 26 (18–35) | 423 | Rising | 1.0 (0.4, 1.7) |
| Idaho | 11.7 (10.8–12.7) | 27 (16–46) | 130 | Falling | -6.5 (-11.2, -0.7) |
| Maine | 11.6 (10.6–12.6) | 28 (15–47) | 120 | Stable | 0.4 (-0.7, 1.4) |
| Vermont | 11.5 (10.1–13.1) | 29 (12–49) | 52 | Stable | 0.1 (-1.1, 1.3) |
| Michigan | 11.5 (11.1–11.9) | 30 (25–38) | 769 | Stable | 0.3 (-0.3, 1.0) |
| Wyoming | 11.4 (9.9–13.1) | 31 (11–49) | 42 | Stable | 1.5 (-0.3, 3.6) |
| Utah | 11.4 (10.7–12.2) | 32 (20–46) | 175 | Rising | 2.4 (1.9, 3.2) |
| Rhode Island | 11.4 (10.3–12.6) | 33 (16–49) | 84 | Stable | 0.0 (-1.2, 1.1) |
| Montana | 11.4 (10.2–12.6) | 34 (16–49) | 81 | Rising | 2.0 (1.2, 3.0) |
| Maryland | 11.3 (10.9–11.8) | 35 (24–42) | 456 | Falling | -3.0 (-5.4, -0.7) |
| New Hampshire | 11.1 (10.1–12.1) | 36 (18–49) | 105 | Stable | 0.8 (-0.2, 1.8) |
| Pennsylvania | 11.0 (10.7–11.3) | 37 (29–44) | 983 | Stable | -2.8 (-6.7, 0.5) |
| Florida | 11.0 (10.7–11.2) | 38 (30–43) | 1,758 | Rising | 0.8 (0.5, 1.2) |
| Arizona | 10.8 (10.4–11.3) | 39 (29–47) | 505 | Falling | -3.3 (-6.5, -1.3) |
| Virginia | 10.8 (10.4–11.2) | 40 (29–47) | 588 | Stable | 0.5 (-1.1, 1.0) |
| New York | 10.8 (10.5–11.0) | 41 (32–45) | 1,436 | Falling | -2.0 (-3.1, -1.2) |
| Washington | 10.8 (10.3–11.2) | 42 (30–47) | 502 | Stable | -0.2 (-2.3, 0.4) |
| Oregon | 10.7 (10.1–11.3) | 43 (29–49) | 300 | Stable | -0.1 (-1.4, 0.4) |
| California | 10.4 (10.3–10.6) | 44 (39–48) | 2,455 | Stable | -0.7 (-2.2, 0.4) |
| Colorado | 10.4 (9.9–10.9) | 45 (33–49) | 345 | Stable | -2.8 (-6.3, 0.7) |
| New Jersey | 10.3 (9.9–10.7) | 46 (37–49) | 633 | Stable | 0.1 (-1.2, 0.5) |
| Connecticut | 10.0 (9.5–10.6) | 47 (37–50) | 247 | Stable | -4.8 (-8.9, 0.1) |
| Massachusetts | 10.0 (9.6–10.4) | 48 (41–50) | 470 | Falling | -0.9 (-3.7, -0.3) |
| Nevada | 9.8 (9.2–10.5) | 49 (38–50) | 187 | Stable | 0.8 (-0.5, 2.4) |
| Hawaii | 8.2 (7.4–9.1) | 50 (49–51) | 81 | Falling | -1.8 (-3.6, -0.5) |
| District of Columbia | 8.2 (6.9–9.6) | 51 (44–51) | 30 | Stable | -2.7 (-19.1, 1.3) |
| Puerto Rico | 5.7 (5.3–6.2) | N/A | 141 | Stable | -1.3 (-10.1, 3.5) |
Among women, Massachusetts ranks 48th out of 51 states/DC for kidney cancer incidence — one of the lowest rates in the country at 10.0 per 100,000, well below the national rate of 12.1. Massachusetts is also one of the few states showing a statistically falling 5-year trend (-0.9), putting it in the company of states like New York, Maryland, and Arizona with declining incidence, while many Midwestern and Southern states (Missouri, Texas, West Virginia) show rising trends. This favorable position contrasts with the county-level late-stage diagnosis concern noted above.
Incidence Compared to Other Cancers in Massachusetts
Data covers 2018–2022, all cancer sites.
| Cancer Site | Massachusetts Rate | U.S. Rate |
| Bladder | 20.2 | 18.8 |
| Brain & ONS | 6.4 | 6.3 |
| Breast (Female) | 137.5 | 131.3 |
| Breast in situ (Female) | 36.4 | 29.8 |
| Cervix (Female) | 4.8 | 7.5 |
| Colon & Rectum | 31.3 | 36.7 |
| Esophagus | 5.2 | 4.6 |
| Kidney & Renal Pelvis | 14.7 | 17.5 |
| Leukemia | 12.9 | 14.3 |
| Liver & Bile Duct | 8.4 | 8.6 |
| Lung & Bronchus | 55.0 | 52.5 |
| Melanoma of the Skin | 15.6 | 23.1 |
| Non-Hodgkin Lymphoma | 18.5 | 18.5 |
| Oral Cavity & Pharynx | 11.1 | 12.1 |
| Ovary (Female) | 9.5 | 10.0 |
| Pancreas | 14.0 | 13.7 |
| Prostate (Male) | 113.1 | 116.4 |
| Stomach | 6.3 | 6.5 |
| Thyroid | 14.4 | 12.9 |
| Uterus (Female) | 27.6 | 27.9 |
Kidney & renal pelvis cancer’s incidence rate in Massachusetts (14.7) is below the national rate (17.5) — one of the larger gaps in the list, alongside melanoma (15.6 vs. 23.1) and cervical cancer (4.8 vs. 7.5). Compared to other cancers affecting Massachusetts residents, kidney cancer ranks in the middle of the pack — well below leading cancers like lung & bronchus (55.0), breast (137.5), and prostate (113.1), but more common than cancers such as cervix, esophagus, and stomach.
Kidney Transplantation in Massachusetts
The following tables draw on data reported for nine Massachusetts transplant centers, largely tied to participation in the National Kidney Registry (NKR).
Transplant Centers
Donor-Related Metrics
| Rank | Center | NKR Transplants (12mo) | Priorit. Deceased Donor | NKR Priorit. Living Donor | Donor Shield | Remote Donation | Voucher Program | NKR Member | Equal Access | Donor Referral Network | Kidney for Life | Donor Care Network | Nutcracker Care Network |
| 1 | Massachusetts General Hospital | 31 | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ❌ | ❌ | ❌ | ❌ |
| 2 | Brigham and Women’s Hospital | 22 | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ❌ |
| 3 | Lahey Hospital & Medical Center | 8 | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ❌ | ❌ | ❌ |
| 4 | Beth Israel Deaconess Medical Center | 7 | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ❌ | ✅ | ❌ | ❌ | ✅ |
| 5 | UMass Memorial Medical Center | 6 | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ❌ | ❌ | ❌ |
| 6 | Baystate Medical Center | 5 | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ | ❌ |
| 7 | Boston Medical Center | 0 | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ |
| 8 | Children’s Hospital Boston | 0 | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ |
| 9 | Tuft’s Medical Center | 0 | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ | ❌ |
| Totals | 79 | 6 | 6 | 6 | 6 | 6 | 6 | 5 | 5 | 2 | 2 | 1 |
Massachusetts General Hospital leads the state with 31 NKR-affiliated donor transplants in the past 12 months, followed by Brigham and Women’s Hospital (22). Six of the nine centers participate actively in NKR donor programs, while Boston Medical Center, Children’s Hospital Boston, and Tuft’s Medical Center show zero NKR donor transplants and no participation in any of the listed donor programs. Brigham and Women’s and Baystate stand out as the only centers offering the full Donor Referral Network, Kidney for Life, and Donor Care Network programs.
Recipient-Related Metrics
| Rank | Center | Kidney for Life | Low Eplet Transplants (12mo) | NKR Transplants (12mo) | NKR Living Donor Tx (prior yr) | Total Living Donor Tx (prior yr) | NKR % of Living Donor Tx | Patient Microsites | Microsite COE | Non-Steroidal Protocol | Voucher Program | NKR Member | Equal Access |
| 1 | Brigham and Women’s Hospital | Y | 3 | 22 | 29 | 30 | 97% | Y | Y | Y | Y | Y | Y |
| 2 | Baystate Medical Center | Y | 2 | 5 | 4 | 7 | 58% | Y | Y | Y | Y | Y | Y |
| 3 | Massachusetts General Hospital | N | 10 | 31 | 31 | 81 | 39% | N | N | Y | Y | Y | Y |
| 4 | Lahey Hospital & Medical Center | N | 4 | 8 | 7 | 12 | 59% | N | N | Y | Y | Y | Y |
| 5 | Beth Israel Deaconess Medical Center | N | 4 | 7 | 5 | 30 | 17% | N | N | Y | Y | Y | N |
| 6 | UMass Memorial Medical Center | N | 0 | 6 | 3 | 10 | 30% | Y | N | Y | Y | Y | Y |
| 7 | Boston Medical Center | N | 0 | 0 | 0 | 9 | 0% | N | N | ? | N | N | N |
| 8 | Children’s Hospital Boston | N | 0 | 0 | 0 | 8 | 0% | N | N | ? | N | N | N |
| 9 | Tuft’s Medical Center | N | 0 | 0 | 0 | 18 | 0% | N | N | ? | N | N | N |
| Totals | 2 | 23 | 79 | 79 | 205 | 39% | 3 | 2 | 6 | 6 | 6 | 5 |
Brigham and Women’s Hospital has by far the highest NKR share of its living donor transplants (97%), meaning nearly all of its living donor cases run through the registry. Massachusetts General Hospital performs the most total living donor transplants (81) but channels a much smaller share (39%) through NKR. Across the state, NKR-facilitated transplants made up 39% of all living donor transplants in the prior year. Boston Medical Center, Children’s Hospital Boston, and Tuft’s Medical Center again report zero NKR-related activity, relying entirely on non-NKR living donor transplants.
Post-Transplant Outcomes
Adult Patients
| Rank | Center | NKR Tx (12mo) | Living Donor Tx (prior yr) | Living Donor 1Yr Graft | 3Yr Graft | 1Yr Patient | 3Yr Patient | Deceased Donor 1Yr Graft | 3Yr Graft | 1Yr Patient | 3Yr Patient |
| 1 | Massachusetts General Hospital | 31 | 81 | 98% | 96% | 99% | 98% | 92% | 86% | 99% | 93% |
| 2 | Brigham and Women’s Hospital | 22 | 30 | 99% | 92% | 98% | 92% | 86% | 89% | 92% | 94% |
| 3 | Lahey Hospital & Medical Center | 8 | 12 | 98% | 93% | 100% | 96% | 90% | 85% | 91% | 90% |
| 4 | Beth Israel Deaconess Medical Center | 7 | 30 | 100% | 100% | 100% | 100% | 94% | 85% | 98% | 89% |
| 5 | UMass Memorial Medical Center | 6 | 10 | 94% | 91% | 94% | 95% | 95% | 90% | 96% | 94% |
| 6 | Baystate Medical Center | 5 | 7 | 95% | 84% | 100% | 84% | 85% | 82% | 91% | 93% |
| 7 | Boston Medical Center | 0 | 9 | 100% | 95% | 100% | 100% | 92% | 86% | 99% | 90% |
| 8 | Tuft’s Medical Center | 0 | 18 | 100% | 100% | 100% | 100% | 93% | 85% | 94% | 87% |
Adult outcomes across Massachusetts transplant centers are strong overall, with most living donor 1-year graft and patient survival rates at or near 100%. Beth Israel Deaconess, Boston Medical Center, and Tuft’s Medical Center report perfect or near-perfect 1-year and 3-year living donor outcomes. Deceased donor outcomes are consistently a few points lower than living donor outcomes across nearly every center — a pattern seen statewide — though even the lowest deceased donor 3-year graft rate (82%, Baystate) remains relatively high.
Pediatric Patients
Children’s Hospital Boston is the only Massachusetts center reporting pediatric transplant outcomes:
| Rank | Center | NKR Tx (12mo) | Living Donor Tx (prior yr) | Living Donor 1Yr Graft | 3Yr Graft | 1Yr Patient | 3Yr Patient | Deceased Donor 1Yr Graft | 3Yr Graft | 1Yr Patient | 3Yr Patient |
| 1 | Children’s Hospital Boston | 0 | 8 | 100% | 100% | 100% | 100% | 100% | 92% | 100% | 100% |
Children’s Hospital Boston’s pediatric results are exceptional — 100% across nearly every measure, with only the 3-year deceased donor graft rate (92%) dipping slightly below perfect.
Kidney Disease Mortality in Massachusetts
Nephritis and Kidney Disease Mortality
This section covers deaths attributed broadly to nephritis and kidney disease.
National vs. State Comparison
- United States age-adjusted death rate: 13.55 per 100,000
- Massachusetts age-adjusted death rate: 13.70 per 100,000
Massachusetts’ overall nephritis/kidney disease death rate (13.70 per 100,000) sits just above the national rate (13.55), making it roughly in line with the U.S. average.
County-Level Death Rates
Massachusetts counties, ranked highest to lowest death rate (per 100,000):
| Rank | County | Age-Adjusted Death Rate |
| 1 | Hampden | 19.81 |
| 2 | Suffolk | 19.06 |
| 3 | Plymouth | 17.98 |
| 4 | Bristol | 17.81 |
| 5 | Essex | 16.27 |
| 6 | Norfolk | 15.77 |
| 7 | Berkshire | 15.35 |
| 8 | Worcester | 15.17 |
| 9 | Middlesex | 14.43 |
| 10 | Hampshire | 13.49 |
| 11 | Franklin | 12.82 |
| 12 | Barnstable | 12.28 |
| 13 | Dukes | 12.12 |
| 14 | Nantucket | 9.45 |
Within the state, there is wide variation in nephritis/kidney disease deaths: Hampden County’s rate (19.81) is more than double Nantucket’s (9.45). The highest-rate counties — Hampden, Suffolk, Plymouth, and Bristol — are all well above the state average, suggesting localized disparities in kidney disease outcomes.
Kidney Cancer (Kidney & Renal Pelvis) Mortality by County
Data covers 2019–2023, all races, both sexes, all ages.
| Geography | Age-Adjusted Death Rate (per 100,000) | CI Rank | Avg. Annual Deaths | Trend | 5-Yr Trend |
| Massachusetts | 2.6 (2.5–2.8) | N/A | 241 | Falling | -2.1 (-2.6, -1.5) |
| United States | 3.4 (3.4–3.5) | N/A | 14,378 | Falling | -1.4 (-2.3, -1.1) |
| Hampden County | 3.9 (3.2–4.7) | 1 (1–4) | 23 | Stable | 0.2 (-1.8, 2.4) |
| Franklin County | 3.6 (2.1–5.9) | 2 (1–12) | 4 | Stable | -0.7 (-3.8, 2.6) |
| Berkshire County | 3.0 (2.0–4.5) | 3 (1–12) | 6 | Stable | -1.9 (-4.6, 0.7) |
| Bristol County | 3.0 (2.5–3.6) | 4 (1–9) | 23 | Falling | -2.8 (-4.1, -1.7) |
| Plymouth County | 3.0 (2.5–3.6) | 5 (2–9) | 22 | Falling | -2.8 (-4.1, -1.6) |
| Worcester County | 2.8 (2.4–3.3) | 6 (2–9) | 32 | Falling | -5.7 (-17.0, -1.7) |
| Norfolk County | 2.7 (2.3–3.2) | 7 (2–10) | 26 | Falling | -1.6 (-2.9, -0.4) |
| Essex County | 2.5 (2.0–2.9) | 8 (4–11) | 27 | Falling | -2.3 (-3.6, -1.2) |
| Middlesex County | 2.3 (2.0–2.7) | 9 (6–11) | 47 | Falling | -2.0 (-3.3, -0.8) |
| Suffolk County | 2.0 (1.5–2.5) | 10 (7–12) | 15 | Falling | -3.4 (-4.8, -2.2) |
| Barnstable County | 1.9 (1.4–2.7) | 11 (6–12) | 10 | Falling | -4.2 (-7.3, -1.5) |
| Hampshire County | 1.9 (1.2–2.9) | 12 (5–12) | 5 | Stable | -2.4 (-7.1, 2.0) |
Note: Dukes and Nantucket counties are not included, likely due to insufficient case counts for reliable estimates.
Massachusetts’ kidney cancer death rate (2.6 per 100,000) is well below the national rate (3.4), and both are on a falling trend. Within the state, Hampden County again has the highest rate (3.9), echoing its position as the highest-rate county for general nephritis/kidney disease mortality — suggesting Hampden faces elevated kidney-related health burdens across multiple conditions. Most counties show a “falling” mortality trend, with Worcester and Barnstable counties showing the steepest declines.
Financial & Insurance Burden of Kidney Failure
Disability, Demographics, and Financial Hardship
- Disability impact: More than 80% of dialysis patients are unable to work — ESRD is classified as a disability, and managing it is more demanding than a full-time job.
- Disproportionate impact on minorities: Among AKF-assisted patients, more than 60% are minorities — 34.7% Black, 20.9% Hispanic/Latino, and 5.2% Native American, Asian, or Pacific Islander.
- Financial hardship: The average income of AKF-assisted patients is less than $25,000 per year, while average out-of-pocket dialysis costs exceed $10,000 per year.
These figures paint a picture of a patient population that is largely unable to work due to the demands of treatment, disproportionately composed of racial and ethnic minorities, and facing out-of-pocket costs that represent a substantial share — over 40% in many cases — of their already-low average income. This combination explains why charitable assistance programs like AKF’s play such a critical role for low-income dialysis and transplant patients in Massachusetts.
Charitable Assistance from the American Kidney Fund (AKF)
| Year | MA Residents Receiving AKF Grants | Charitable Assistance Provided |
| 2020 | 703 | $2,000,000 |
| 2022 | 547 | $1,734,433 |
| 2024 | 459 | $1,322,962 |
Both the number of Massachusetts residents receiving AKF assistance and the total dollar amount provided have declined steadily from 2020 to 2024 — recipients dropped by roughly 35% and total assistance by about a third over that period. This trend runs counter to the rising number of residents living with kidney failure noted earlier in this article, suggesting either reduced funding availability, eligibility changes, or reduced need for this specific form of assistance over time relative to the growing patient population.
Insurance Coverage Among AKF Assistance Recipients
- Medicare Part B: 40.9% (2022) → 25% (2024)
- Medicare Advantage: 1.3% (2022) → 0.6% (2024)
- Medigap: 27.2% (2022) → 27.3% (2024)
- Commercial Employer Group Plans (incl. COBRA): 17.7% (2022) → 20.1% (2024)
Traditional Medicare Part B coverage among AKF recipients dropped sharply, from 40.9% in 2022 to 25% in 2024, while commercial employer-based coverage rose moderately (17.7% to 20.1%). Medigap held essentially steady at just over a quarter of recipients. Medicare Advantage remains a minor share of coverage among assistance recipients in both years, despite growing nationally (see below).
Conclusion
Massachusetts shows a mixed picture across kidney-related conditions. The state’s kidney failure (ESRD) population is growing — by roughly 23–29% over the past decade — straining a transplant waiting list of over 3,000 residents even as transplant volume itself has grown by more than 50% since the mid-2010s. Diabetes and high blood pressure remain the dominant drivers, and charitable assistance from organizations like the American Kidney Fund, while declining in recent years, continues to support hundreds of low-income residents annually.
On mortality, Massachusetts tracks close to the national average for general kidney disease deaths but performs better than the nation on kidney cancer mortality and incidence, ranking among the states with the lowest and most rapidly falling kidney cancer rates. Transplant outcomes across the state’s centers are also strong, with most facilities reporting living donor survival rates at or near 100% and deceased donor rates trailing only modestly behind.
Within the state, Hampden County consistently emerges as a hotspot — appearing at or near the top for kidney disease mortality, kidney cancer mortality, and kidney cancer incidence alike. This pattern, set against a backdrop of patients who are largely unable to work, disproportionately drawn from minority communities, and facing steep out-of-pocket costs relative to income, points to where future public health attention in Massachusetts may be most needed.
Sources:
- Kidney Transplant Centers in Massachusetts
- Chronic Disease in Holyoke, MA
- Explore Chronic Kidney Disease in Massachusetts | AHR
- Kidney failure (ESRD) – in Massachusetts
- Kidney failure
- Kidney failure in Massachusetts: 2023
- Kidney failure-related excess mortality during the first three years of the COVID-19 pandemic in the United States: a nation-wide, population-based analysis – PMC
- Massachusetts Nephritis/Kidney Disease
- Death Rate Report for Massachusetts by County Kidney & Renal Pelvis, 2019-2023
- ESRD Enrollment in MA Now Exceeds 30% of Dialysis Patients | Avalere Health Advisory
- Incidence Rate Report for Massachusetts by County Kidney & Renal Pelvis (Late Stage), 2018-2022
- Incidence Rate Report by State Kidney & Renal Pelvis (All Stages), 2018-2022
- Massachusetts Cancer Incidence: Quick Profile | HDPulse Data Portal