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Kidney Disease Statistics in Oklahoma, USA

Oklahoma faces a significant and growing kidney disease crisis. As of the most recent reporting period, 8,860 Oklahomans are living with kidney failure — a 31% increase since 2013 — with 6,365 depending on dialysis to survive and just 2,495 living with a kidney transplant. Diabetes and high blood pressure, which together account for over 70% of all new kidney failure cases, remain the primary drivers of the epidemic in the state.

Access to transplantation remains critically limited: only about 1 in 3 Oklahomans on the waiting list receives a kidney transplant in any given year, and the waiting list has grown from 478 in 2020 to 670 in 2025. The financial toll is equally severe — dialysis costs Medicare nearly $86,000 per patient annually, yet more than 80% of dialysis patients cannot work, leaving thousands reliant on charitable grants just to maintain insurance coverage.

Beyond kidney failure, Oklahoma carries a disproportionate kidney cancer burden, ranking 5th in the nation for incidence and 4th for mortality. The state’s kidney cancer incidence has risen 71% since 1999 — nearly twice the national rate — while the mortality gap stands at 41.2% above the U.S. average, one of the largest for any cancer type in Oklahoma. This article presents all available data on kidney failure, transplantation, financial impact, and kidney cancer in Oklahoma — including county-level analysis across the state.

Chronic Kidney Disease in Oklahoma

Chronic kidney disease (CKD) refers to the gradual, long-term loss of kidney function and represents an earlier stage of disease that can progress to kidney failure if unmanaged. The data available on CKD in Oklahoma is limited but points to notable prevalence and a potential gap between the actual burden and reported diagnosis rates.

4.4% of Oklahoma adults report ever being told by a health professional that they have kidney disease (excluding kidney stones, bladder infections, and incontinence)
Oklahoma’s national ranking for self-reported CKD: 35th out of 50 states
Oklahoma patients on Medicare diagnosed with CKD: 2,568

Oklahoma’s 35th-place ranking for self-reported CKD suggests that CKD may be underdiagnosed or underreported in Oklahoma, with many residents unaware of their condition until it has already advanced

Kidney Failure in Oklahoma

Current Burden

The most recent data shows that nearly 9,000 Oklahomans are living with kidney failure — a life-threatening condition that requires either dialysis or a transplant to survive.

Oklahomans living with kidney failure: 8,860
Oklahomans on dialysis: 6,365
Oklahomans living with a kidney transplant: 2,495
Increase in total kidney failure cases since 2013: +31%

Approximately 72% of all kidney failure patients in Oklahoma are on dialysis, while fewer than 28% have received a kidney transplant.

Historical Trends

Oklahoma’s kidney failure burden has grown substantially across every reporting period tracked. The table below reflects figures published in each year’s annual report.

Report Year	Total with Kidney Failure	On Dialysis	Living with Transplant	Growth from Earlier Baseline
2021 report	8,324	6,051	2,273	+24.4% since 2009
2022 report	8,555	6,195	2,360	+24.4% since 2009
2023 report	8,508	6,127	2,381	+38.1% since 2010
2025 report	8,658	6,255	2,403	+32% since 2012
2026 report	8,860	6,365	2,495	+31% since 2013

The total number of Oklahomans living with kidney failure has increased consistently across all reporting periods.

New Cases by Year

Each year, hundreds of Oklahomans are newly diagnosed with kidney failure. The table below shows annual new diagnoses and the treatment path taken by newly diagnosed patients.

Diagnosis Year	New Cases	Began Dialysis	Received Transplant
2018	1,661	1,636	25
2019	1,693	1,656	37
2020	1,637	1,600	37
2022	1,747	1,713	34
2023	1,649	1,610	39

In every year of available data, the vast majority of newly diagnosed patients begin dialysis rather than receiving a transplant.

Leading Causes

Two chronic conditions — diabetes and high blood pressure — are responsible for the majority of kidney failure cases in Oklahoma. The following figures are drawn from multiple annual reports.

Report Year	Diabetes (% of cases)	High Blood Pressure (% of cases)	Combined
2022 report	47%	28%	75%
2023 report	47%	30%	77%
2025 report	43%	30%	73%

Together, diabetes and high blood pressure account for approximately 73–77% of all kidney failure cases.

The diabetes share shows a modest decline in the most recent report (from 47% to 43%), while hypertension has remained steady at 28–30%.

Risk Factors

Oklahoma’s population carries an elevated burden of the risk factors most strongly associated with kidney disease. The following figures reflect self-reported and diagnosed rates among Oklahoma adults.

12.2% of Oklahomans have been diagnosed with diabetes
37.8% have high blood pressure
36.8% self-report as obese

More than one-third of Oklahoma’s population has high blood pressure and a similar proportion reports obesity — both leading drivers of kidney failure.

Kidney Cancer in Oklahoma

Overview and National Rankings

Kidney cancer is one of Oklahoma’s most significant cancer burdens. In 2022, it was the 6th most commonly diagnosed cancer in the state. From 2017 to 2021, 4,873 new cases were diagnosed in Oklahoma, representing approximately 4.5–4.6% of all cancer diagnoses.

National Rankings for Oklahoma (Compared to All Other States)

5th highest age-adjusted incidence rate (2018–2022)
4th highest age-adjusted mortality rate (2019–2023)

Rankings within Oklahoma’s Cancer Landscape (2017–2021)

5th most diagnosed cancer overall
5th most diagnosed cancer among men
7th most diagnosed cancer among women
One of the five cancers accounting for nearly 50% of all new Oklahoma cancer diagnoses in 2022

Oklahoma vs. U.S. Incidence Rates

Oklahoma residents develop kidney cancer at significantly higher rates than Americans nationally.

Metric	Oklahoma	United States	OK vs. U.S.
Incidence rate (2018–2022)	22.0 per 100,000	17.5 per 100,000	+23.1%
Total new cases (2018–2022)	5,044	352,960	1.4% of U.S. total

Additional Context

The incidence rate for kidney and renal pelvis cancer has more than doubled in Oklahoma in the last 20 years
Over 60% of kidney cancer cases in Oklahoma occur in males

Oklahoma’s kidney cancer burden is consistently and substantially above the national average in both incidence and mortality, placing it among the most severely affected states in the nation.

Incidence by Race, Sex, Age, and Ethnicity

American Indian and Alaska Native (AI/AN) Oklahomans face dramatically elevated kidney cancer incidence — the highest of any racial or ethnic group in the state.

Incidence by Race/Ethnicity (2018–2022)

Race/Ethnicity	Incidence (per 100,000)
NH White	20.3
NH Black	19.7
NH American Indian/Alaska Native	46.7
NH Asian	8.3
Hispanic	17.9

AI/AN vs. NH White incidence comparison:

Oklahoma AI/AN incidence: 2.1 times higher than NH White
Oklahoma AI/AN vs. White incidence rate ratio: 2.04 (32.3 vs. 15.8 per 100,000)
U.S. AI/AN vs. White incidence rate ratio: 0.89 — nationally, AI/ANs have lower rates than Whites

Incidence by Race and Sex (2017–2021)

Race/Ethnicity	Male Incidence (per 100,000)	Female Incidence (per 100,000)
NH White	26.5	15.6
NH Black	23.1	15.7
NH AIAN	44.2	26.4
NH Asian	11.0	7.1
Hispanic	22.3	15.6

The AI/AN incidence rate of 46.7 per 100,000 is more than twice the state average and over four times higher than the rate among NH Asians (8.3).

Age-Adjusted Incidence Rates by Sex

Sex	Incidence (2022 Snapshot)	Incidence (2017–2021)
Male	30.3 per 100,000	27.0 per 100,000
Female	15.7 per 100,000	16.3 per 100,000

Oklahoma’s kidney cancer incidence rate of 22.0 per 100,000 is 23.1% above the national average.

Incidence by Age Group

Kidney cancer incidence escalates sharply with increasing age, peaking in the 75–79 age group before declining slightly in the oldest group.

Age Group	Incidence (per 100,000)
35–39	9.6
40–44	16.9
45–49	25.7
50–54	38.9
55–59	49.7
60–64	58.6
65–69	79.9
70–74	81.9
75–79	90.5
80–84	84.6
85+	62.4

Incidence rises steeply from age 40 onward, roughly doubling with each decade until reaching its peak of 90.5 per 100,000 in the 75–79 age group.

Stage at Diagnosis

Most kidney cancers in Oklahoma are caught at the localized stage, where outcomes are most favorable. Stage distribution is broadly similar to the national picture, with slight differences in the share of unknown-stage diagnoses.

Stage Distribution

2017–2021

Stage	Oklahoma	United States
Localized	65.5%	67.5%
Regional	15.1%	15.6%
Distant	14.0%	13.4%
Unknown	5.4%	3.5%

2018–2022

Stage	Oklahoma	United States
Local	67%	67%
Regional	16%	16%
Distant	14%	13%
Unstaged	3%	3%

Late-Stage Incidence

Overall Late-Stage Incidence (2018–2022)

Geography	Rate (per 100,000)	% of Cases Diagnosed Late
Oklahoma	6.2	29.3%
United States	5.0	29.1%

Counties with the Highest Late-Stage Kidney Cancer Incidence (2018–2022)

County	Rural/Urban	Late-Stage Rate (per 100,000)	% Cases Late Stage
Caddo	Rural	10.5	38.6%
Mayes	Rural	8.9	28.4%
Delaware	Rural	8.6	39.1%
Cherokee	Rural	8.3	26.6%
Stephens	Rural	8.3	31.6%
Ottawa	Rural	8.2	43.6%
Carter	Rural	7.9	33.3%
Grady	Urban	7.9	38.5%
Creek	Urban	7.6	31.9%
Muskogee	Rural	7.5	34.0%

Counties with the Lowest Late-Stage Incidence

County	Rural/Urban	Late-Stage Rate (per 100,000)	% Cases Late Stage
Garfield	Urban	4.3	30.9%
Logan	Urban	4.9	30.4%
Canadian	Urban	4.9	22.8%

Oklahoma’s 2017–2021 data shows a higher proportion of unknown-stage diagnoses (5.4% vs. 3.5% nationally), suggesting gaps in complete staging at the time of diagnosis.

Incidence by County (All Stages, 2018–2022)

The table below presents age-adjusted kidney cancer incidence rates for all Oklahoma counties with available data, ranked from highest to lowest. State average: 22.0 per 100,000.

Rank (1=Highest)	County	Rural/Urban	Rate (per 100,000)	Recent Trend
1	Okfuskee	Rural	40.2	—
2	Marshall	Rural	33.9	Stable
3	Craig	Rural	33.7	Stable
4	Mayes	Rural	33.1	Rising
5	Seminole	Rural	32.1	Rising
6	Adair	Rural	31.0	Stable
7	Cherokee	Rural	30.0	Stable
8	Lincoln	Urban	29.3	Rising
9	Pawnee	Urban	28.6	Rising
10	Hughes	Rural	28.4	Stable
11	Caddo	Rural	28.0	Stable
12	Okmulgee	Urban	28.0	Rising
13	Garvin	Rural	27.8	Stable
14	McCurtain	Rural	27.3	Stable
15	Pontotoc	Rural	26.6	Stable
16	Creek	Urban	26.6	Rising
17	Johnston	Rural	26.4	—
18	Pottawatomie	Rural	26.4	Rising
19	Stephens	Rural	24.9	Stable
20	Carter	Rural	24.9	Rising
21	McIntosh	Rural	24.9	Stable
22	Kingfisher	Rural	24.2	Stable
23	Kay	Rural	24.0	Stable
24	Pushmataha	Rural	23.9	—
25	Bryan	Rural	23.6	Rising
26	Rogers	Urban	23.6	Stable
27	McClain	Urban	23.5	Rising
28	Noble	Rural	23.4	—
29	Payne	Rural	23.3	Rising
30	Washington	Rural	23.0	Stable
31	Muskogee	Rural	22.9	Rising
32	Woodward	Rural	22.8	—
33	Delaware	Rural	22.7	Stable
34	Haskell	Rural	22.6	Stable
35	Nowata	Rural	22.5	—
36	Custer	Rural	22.3	Stable
37	Le Flore	Rural	22.2	Stable
38	Choctaw	Rural	22.2	Stable
39	Beckham	Rural	22.1	Stable
40	Tulsa	Urban	21.9	Stable
41	Jackson	Rural	21.8	Stable
42	Grady	Urban	21.8	Stable
43	Atoka	Rural	21.7	—
44	Comanche	Urban	21.7	Rising
45	Sequoyah	Urban	21.1	Stable
46	Ottawa	Rural	20.8	Stable
47	Canadian	Urban	20.7	Stable
48	Wagoner	Urban	20.4	Stable
49	Cleveland	Urban	20.4	Rising
50	Pittsburg	Rural	20.3	Rising
51	Murray	Rural	19.9	—
52	Oklahoma	Urban	18.5	Rising
53	Osage	Urban	18.0	Stable
54	Texas	Rural	17.7	—
55	Logan	Urban	16.3	Stable
56	Garfield	Urban	15.2	Stable

County-level incidence varies by more than 2.6-fold across Oklahoma — from a high of 40.2 per 100,000 in Okfuskee County to a low of 15.2 in Garfield County.

Kidney Transplants in Oklahoma

Waiting List and Annual Transplant Volume

Only about 1 in 3 Oklahomans on the kidney transplant waiting list receives a transplant in any given year. The table below tracks waiting list size and transplant volumes over time.

Year	Waiting List	Total Transplants	Living Donor Tx	Deceased Donor Tx	Change vs. ~10 Years Prior
2016	520	209	—	—	—
2020	478	197	—	—	—
2021	514	173	31	142	−3.4% vs. 2011
2022	552	192	32	160	+6.1% vs. 2012
2024	652	212	40	172	−2% vs. 2014
2025	670	192	44	148	−16% vs. 2015

The waiting list has grown substantially — from 478 in 2020 to 670 in 2025 — while transplant volumes have not kept pace.

Transplant Centers

Oklahoma has five kidney transplant centers, all located in Oklahoma City and Tulsa. The list below shows living donor transplant volumes for the most recently reported period (April 1, 2025 – March 31, 2026).

Integris Baptist Medical Center — 22 living donor transplants
St John Medical Center — 12 living donor transplants
Oklahoma City Medical Center — 0 living donor transplants
Oklahoma University Transplant Center — 0 living donor transplants
SSM Health St. Anthony Hospital Oklahoma City — 0 living donor transplants

Total: 34 living donor transplants

All five centers show no participation in NKR (National Kidney Registry) programs, including NKR Transplants, Donor Shield, Remote Donation, the Voucher Program, Kidney for Life, Patient Microsites, the Equal Access Commitment Center, and Non-Steroidal Protocol.

Living donor transplant activity is concentrated in just two of five centers, with three reporting zero living donor transplants in the most recent period.

Adult Transplant Outcomes

The two Oklahoma centers with reported data both show strong transplant outcomes. The tables below present 1-year and 3-year graft and patient survival rates for adult recipients.

Living Donor Transplant Outcomes

Center	Tx Volume	1-Year Graft Survival	3-Year Graft Survival	1-Year Patient Survival	3-Year Patient Survival
Integris Baptist Medical Center	22	91%	98%	98%	97%
St John Medical Center	12	93%	100%	97%	100%

Deceased Donor Transplant Outcomes

Center	1-Year Graft Survival	3-Year Graft Survival	1-Year Patient Survival	3-Year Patient Survival
Integris Baptist Medical Center	97%	86%	99%	89%
St John Medical Center	92%	87%	93%	92%

Both centers demonstrate strong outcomes for living donor transplants, with 3-year patient survival at 97–100%.

Kidney Disease Mortality in Oklahoma

Chronic Kidney Disease Mortality

The following figures reflect age-adjusted mortality attributed to kidney disease in Oklahoma.

Age-adjusted kidney disease death rate: 10.9 per 100,000
Annual kidney disease deaths: 530

With 530 Oklahomans dying from kidney disease annually and a death rate of 10.9 per 100,000, kidney disease mortality represents a substantial ongoing burden.

Kidney Disease (Nephritis and Nephrosis) Mortality by County

Deaths attributed to kidney disease (nephritis and nephrosis) add an additional layer of mortality burden across the state. Oklahoma’s overall rate is below the U.S. average, but county-level variation is extreme.

Oklahoma: 11.4 per 100,000 (recent trend: falling, −2.9%)
United States: 13.4 per 100,000 (recent trend: stable)
Period: 2019–2023

County	Rate (per 100,000)	Avg. Annual Deaths	Recent Trend
Coal	47.3	3	—
Okfuskee	25.1	4	—
Hughes	23.4	4	—
Texas	22.0	4	—
McCurtain	21.8	9	—
Bryan	20.8	12	—
Choctaw	20.4	4	—
Ottawa	20.0	7	—
Custer	19.4	6	—
Caddo	19.0	6	—
Pontotoc	18.4	9	—
Stephens	18.4	11	—
Sequoyah	18.1	10	—
Pushmataha	17.9	3	—
Seminole	16.4	5	—
Garfield	16.1	12	—
Kay	15.7	9	—
Beckham	15.3	4	—
Washington	15.3	13	—
Adair	14.0	3	—
Muskogee	14.0	11	—
Garvin	13.3	5	—
McIntosh	13.1	4	—
Comanche	12.9	15	Stable (−1.4)
Jackson	12.6	4	—
Marshall	12.5	3	—
Pottawatomie	12.3	10	—
Le Flore	11.4	7	—
Oklahoma	11.0	91	Falling (−1.8)
Pittsburg	11.0	7	—
Carter	10.6	6	—
Delaware	10.1	6	—
Grady	10.1	6	—
Lincoln	10.1	4	—
Okmulgee	9.9	5	—
Mayes	9.6	5	—
Osage	9.4	6	—
Creek	9.1	8	—
Canadian	8.9	13	—
McClain	8.9	4	—
Tulsa	8.7	62	Falling (−4.4)
Cherokee	8.5	5	—
Payne	8.3	7	—
Cleveland	8.2	25	Falling (−4.1)
Wagoner	7.8	8	—
Rogers	7.5	9	—

While Oklahoma’s overall kidney disease death rate (11.4) is below the national figure (13.4), the county-level data reveals extreme disparities. Coal County’s rate (47.3) is more than four times the state average and over six times that of the lowest counties.

Kidney Cancer Mortality

Oklahoma vs. U.S. Kidney Cancer Mortality Rates

Oklahoma residents die from kidney cancer at significantly higher rates than Americans nationally.

Metric	Oklahoma	United States	OK vs. U.S.
Mortality rate (2019–2023)	4.8 per 100,000	3.4 per 100,000	+41.2%
Total deaths (2019–2023)	1,148	71,890	1.6% of U.S. total

Mortality by Race, Age, Sex, and Ethnicity

American Indian and Alaska Native (AI/AN) Oklahomans face the highest kidney cancer mortality rates of any racial or ethnic group, and the true burden is likely even higher than reported figures indicate.

Mortality by Race/Ethnicity (2019–2023)

Race/Ethnicity	Mortality (per 100,000)
NH White	4.8
NH Black	4.1
NH American Indian/Alaska Native	7.6†
NH Asian	Suppressed
Hispanic	2.9

Mortality by Race and Sex (2018–2022)

Race/Ethnicity	Male Mortality (per 100,000)	Female Mortality (per 100,000)
NH White	7.1	2.8
NH Black	10.3	Suppressed
NH AIAN	13.5	3.9
NH Asian	Suppressed	Suppressed
Hispanic	6.4	Suppressed

AI/AN Oklahomans face kidney cancer mortality rates nearly double the state average. NH Black men also face elevated mortality (10.3 per 100,000), exceeding the NH White male rate (7.1).

Mortality by Age Group

Kidney cancer mortality rises steadily with age and reaches its highest point in the oldest age group.

Age Group	Mortality (per 100,000)
45–49	2.5
50–54	4.7
55–59	5.8
60–64	12.7
65–69	14.5
70–74	26.4
75–79	26.2
80–84	32.7
85+	43.7

Unlike incidence — which peaks at 75–79 and then declines — mortality continues to climb through the 85+ age group (43.7 per 100,000), the highest of any age group.

Age-Adjusted Mortality Rates by Sex

Sex	Mortality (2017–2021)
Male	6.8 per 100,000
Female	3.1 per 100,000

Oklahoma accounts for 1.4% of U.S. kidney cancer cases but 1.6% of deaths, meaning Oklahomans die from kidney cancer at a rate disproportionate even to their elevated incidence.

Five-Year Relative Survival by Stage

Survival from kidney cancer in Oklahoma is broadly comparable to national figures, with slight advantages over the U.S. for regional, distant, and unstaged disease. Data covers 2018–2022.

Local stage: Oklahoma 90.5% vs. United States 91.4%
Regional stage: Oklahoma 74.6% vs. United States 73.3%
Distant stage: Oklahoma 20.7% vs. United States 19.2%
Unstaged: Oklahoma 57.6% vs. United States 54.0%

The survival gap between local-stage (90.5%) and distant-stage (20.7%) kidney cancer in Oklahoma exceeds 70 percentage points, making stage at diagnosis the single most powerful determinant of survival.

Kidney Cancer Mortality by County (2019–2023)

The following table shows kidney cancer death rates for counties with available data. State average: 4.8 per 100,000 | U.S. average: 3.4 per 100,000.

County	Rural/Urban	Death Rate (per 100,000)	Recent 5-Year Trend
Seminole	Rural	9.5	—
Okmulgee	Urban	8.2	—
Mayes	Rural	7.5	—
Muskogee	Rural	7.2	Stable (+0.4)
Stephens	Rural	7.1	Stable (+0.9)
Lincoln	Urban	6.9	Stable (−0.6)
Pottawatomie	Rural	6.7	Stable (−0.6)
Sequoyah	Urban	6.2	—
Carter	Rural	5.8	Stable (+2.2)
Comanche	Urban	5.8	Stable (+0.2)
Garfield	Urban	5.3	Stable (+0.2)
Le Flore	Rural	5.3	Stable (−0.5)
Delaware	Rural	5.2	Stable (−0.9)
Rogers	Urban	4.8	Stable (−1.4)
Creek	Urban	4.6	Stable (−0.8)
Canadian	Urban	4.5	Stable (−0.2)
Pittsburg	Rural	4.5	—
Grady	Urban	4.5	—
Payne	Rural	4.2	—
Tulsa	Urban	4.2	Stable (−0.9)
Oklahoma	Urban	4.0	Stable (−0.6)
Wagoner	Urban	3.6	—
Cleveland	Urban	3.5	Stable (−1.6)

Seminole County has the highest kidney cancer mortality rate (9.5 per 100,000) — 2.7 times that of Cleveland County (3.5), the lowest.

Financial Burden of Kidney Failure

Medicare Costs

Kidney failure is extraordinarily expensive to treat. Medicare — the primary payer for most kidney failure patients — covers the bulk of costs, though patient financial burdens remain substantial.

Treatment Costs per Patient

Average annual Medicare costs:

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

Medicare-Enrolled Kidney Disease Patients

Data associated with the 2016 reporting period:
Medicare patients diagnosed with CKD: 2,568
Medicare dialysis patients: 4,957
Medicare patients with a kidney transplant: 3,973
Transplants performed (2016): 209
Patients who died while on the waiting list (2016): 26

The Medicare cost of dialysis ($85,979/year) is nearly 2.6 times higher than post-transplant care ($32,586/year).

American Kidney Fund (AKF) Charitable Assistance

Because kidney failure is classified as a disability — with more than 80% of dialysis patients unable to work — and because out-of-pocket costs can exceed 40% of the average patient’s annual income, many Oklahomans with kidney failure depend on charitable assistance to maintain insurance coverage. The AKF provides grants for premiums and other healthcare costs not covered by insurance.

Year	Oklahoma Recipients	Total AKF Assistance
2020	1,857	~$5,000,000
2021	1,607	$5,219,297
2022	1,555	$5,064,214
2024	1,562	$5,548,119
2025	1,680	—

Key financial context:

Average annual income of AKF-assisted patients: less than $25,000
Average annual out-of-pocket cost for dialysis patients: more than $10,000
Out-of-pocket costs as a share of income: more than 40%
Among AKF patients nationally: 34.7% are Black, 20.9% are Hispanic/Latino, 5.2% are Native American, Asian, or Pacific Islander

Between 1,555 and 1,857 Oklahomans have received AKF grants in each year from 2020 to 2025, with total annual assistance consistently exceeding $5 million.

Insurance Coverage Among AKF-Assisted Patients

The following table shows the breakdown of insurance coverage types held by Americans who received AKF charitable premium assistance (reflects the national AKF-assisted population by year).

Insurance Type	2021	2022	2024
Medicare Part B	36.8%	40.9%	25.0%
Medigap	31.1%	27.2%	27.3%
Employer Group Health Plans (incl. COBRA)	18.9%	17.7%	20.1%
Commercial Plans	10.5%	—	—
Exchange Plans	3.4%	—	—
Medicare Advantage	1.2%	1.3%	0.6%
Annuity	1.5%	—	—
Medicaid	0.1%	—	—

Medicare Part B and Medigap together consistently account for the largest shares of insurance types among AKF-assisted patients, reflecting the high proportion of kidney failure patients enrolled in Medicare.

Conclusion

Oklahoma’s kidney failure burden is large, growing, and increasingly difficult to address through transplantation alone. The total number of patients has risen by 24–38% depending on the baseline period, and fewer than 3% of newly diagnosed patients receive a transplant in the year of their diagnosis. With 670 patients on the waiting list and only 192 transplants performed in 2025 — a 16% decline from 2015 — the gap between supply and demand continues to widen. None of Oklahoma’s five transplant centers currently participates in NKR programs that could expand transplant opportunities through paired exchange and donor chains.

Kidney cancer in Oklahoma presents a distinct and urgent challenge. Incidence has more than doubled over the last 20 years at nearly twice the national rate of increase, and mortality remains 41.2% above the U.S. average — the second largest cancer mortality gap of any cancer type in the state. The AI/AN population faces incidence rates more than twice the state average — a disparity unique to Oklahoma that does not exist at the national level. County-level incidence ranges from 15.2 to 40.2 per 100,000, a more than 2.6-fold variation, with the highest-burden counties overwhelmingly rural and concentrated in eastern and central Oklahoma.

Across all forms of kidney disease, Oklahoma’s data consistently reflects the same underlying patterns: elevated rates of chronic disease risk factors (diabetes, hypertension, obesity), pronounced urban-rural disparities, and severe racial inequities — particularly for the American Indian and Alaska Native population. Kidney disease death rates are falling in the state’s three largest urban counties, but remain high or statistically unassessable in most rural counties. The convergence of high risk factor burden, inadequate transplant access, financial hardship among patients, and geographic inequity underscores the need for sustained and targeted public health investment across Oklahoma.