Kidney disease is one of the most pervasive and underdiagnosed chronic conditions affecting Pennsylvanians today. From early-stage Chronic Kidney Disease (CKD) to end-stage renal failure requiring dialysis or transplantation, the burden spans nearly every county, age group, and demographic in the commonwealth. With nearly one million Pennsylvanians estimated to have CKD and close to 30,000 living with kidney failure, the scale of the crisis is both vast and often invisible.
The consequences of kidney disease extend far beyond health outcomes. For the tens of thousands of Pennsylvanians on dialysis — a life-sustaining treatment that functions as a more than full-time commitment — the financial, occupational, and social costs are devastating. More than 80% of dialysis patients cannot work, the average out-of-pocket cost exceeds $10,000 per year, and the average income of those seeking assistance falls below $25,000. These figures underscore that kidney disease is not only a medical emergency but a social and economic one as well.
This article draws exclusively on available Pennsylvania-specific data to present a comprehensive statistical portrait of kidney disease in the state. It covers chronic kidney disease prevalence, end-stage renal disease trends, transplant access, cancer incidence and mortality, geographic disparities across all 67 counties, and the financial burden borne by patients and the healthcare system alike.
Chronic Kidney Disease (CKD)
Statewide Prevalence
Chronic Kidney Disease (CKD) is a significant public health concern in Pennsylvania. The following figures capture the scope of the disease across the adult population, including how Pennsylvania compares to national averages and its standing among U.S. states.
- 4.7% of Pennsylvania adults reported ever being told by a health professional that they had kidney disease (excluding kidney stones, bladder infections, and incontinence)
- Pennsylvania’s national rank: 41st (among U.S. states)
- An estimated 997,402 patients in Pennsylvania have been diagnosed with CKD
- More than 1 in 7 U.S. adults (approximately 37 million people, or 15%) are estimated to have CKD nationally
- As many as 9 in 10 adults with CKD do not know they have it
- About 2 in 5 adults with severe CKD do not know they have it
- 14.63% of Pennsylvania Medicare patients have been diagnosed with CKD
Pennsylvania’s CKD prevalence of 4.7% places it among the more affected states nationally. The extremely low awareness rates — both nationally and by extension in Pennsylvania — underscore a critical gap between actual disease burden and diagnosis, making population-level screening and education essential.
CKD Prevalence by Demographic Group
By Age Group
Age is a primary risk factor for CKD. The following data compares Pennsylvania’s age-stratified CKD rates against U.S. averages.
| Age Group | Pennsylvania | U.S. Average |
| Ages 18–44 | 1.5% | 1.4% |
| Ages 45–64 | 4.5% | 4.4% |
| Age 65+ | 10.3% | 9.0% |
Pennsylvania’s CKD rates exceed the national average in all three age brackets, with the most notable gap occurring in the 65+ population, where Pennsylvania’s rate (10.3%) is more than a full percentage point above the U.S. average (9.0%).
By Race/Ethnicity
Certain racial and ethnic groups face a significantly higher risk of developing CKD compared to Caucasians.
| Race/Ethnicity | Relative Risk vs. Caucasians |
| African Americans | 4x more likely |
| Asians | 1.4x more likely |
| Native Americans | 1.4x more likely |
| Hispanics | 1.3x more likely |
African Americans face a dramatically elevated risk — four times more likely to develop CKD than Caucasians — which is also reflected in the AKF assistance data showing that 34.7% of AKF-assisted Pennsylvania patients are Black.
By Medicare Population (Lancaster County)
Lancaster County serves as a specific county-level data point for CKD burden among Medicare beneficiaries.
- CKD rate among Medicare patients in Lancaster County: 20%
- Ranked in the worst 25% of U.S. states
- Higher and worse than the U.S. average of 18.0%
- Higher and worse than the prior reported value of 19%
Lancaster County’s Medicare CKD rate of 20% — already above both the national average and the county’s own prior measurement — suggests a worsening trend in this population. This finding points to the need for targeted interventions among older insured residents in this region.
CKD Disease Burden Over Time — Pennsylvania vs. Other States
From 2002 to 2016, all U.S. states saw an increase in CKD Disability-Adjusted Life Years (DALYs). The following shows where Pennsylvania ranks in terms of the magnitude of that increase.
States with the LARGEST Increase in Age-Standardized CKD DALY Rates (2002–2016):
| Rank | State | % Increase |
| 1 | Oklahoma | 32.9% |
| 2 | West Virginia | 31.3% |
| 3 | Texas | 30.9% |
| 4 | New Mexico | 30.7% |
| 5 | Iowa | 30.1% |
| 6 | Washington | 28.5% |
| 7 | Idaho | 28.2% |
| 8 | Tennessee | 27.9% |
| 9 | Arkansas | 27.8% |
| 10 | Kentucky | 26.3% |
States with the SMALLEST Increase in Age-Standardized CKD DALY Rates (2002–2016):
| Rank | State | % Increase |
| 1 | Nevada | 6.3% |
| 2 | New Jersey | 6.8% |
| 3 | Massachusetts | 8.8% |
| 4 | Maryland | 9.3% |
| 5 | Illinois | 10.4% |
| 6 | New York | 10.8% |
| 7 | Connecticut | 11.3% |
| 8 | Pennsylvania | 12.0% |
| 9 | Georgia | 12.7% |
| 10 | Colorado | 13.6% |
Pennsylvania ranks 8th among states with the lowest growth in CKD disease burden between 2002 and 2016, with a 12.0% increase — substantially lower than the worst-affected states like Oklahoma (32.9%). While this is relatively favorable, an absolute increase still represents thousands of additional affected residents, and the trend cannot be interpreted as improvement, only as slower worsening.
Kidney Failure
Leading Causes of Kidney Failure
Diabetes and high blood pressure are the primary drivers of both CKD and kidney failure in Pennsylvania.
- Diabetes accounts for 44% of all kidney failure cases
- High blood pressure accounts for 29% of all kidney failure cases
- Together, these two conditions account for approximately 74% of all kidney failure in the state
- Both are largely preventable and manageable chronic conditions
The dominance of diabetes and high blood pressure as causes of kidney failure means that a significant portion of Pennsylvania’s kidney failure burden could potentially be reduced through better chronic disease prevention and management upstream of renal deterioration.
Kidney Failure (End-Stage Renal Disease)
Kidney failure, or End-Stage Renal Disease (ESRD), is the most severe stage of CKD. Without dialysis or a transplant, it is fatal. The following table tracks Pennsylvania’s kidney failure burden over time.
| Year of Report | Total Living with Kidney Failure | On Dialysis | Living with Transplant |
| 2021 (2021 data) | 29,592 | 19,774 | 9,818 |
| 2024 (2021 data) | 29,480 | 19,067 | 10,413 |
| 2025 (2022 data) | 29,338 | 18,734 | 10,604 |
New Kidney Failure Cases Diagnosed
| Data Year | New Cases | Received Transplant | Began Dialysis |
| 2018 | 4,918 | 146 | 4,772 |
| 2021 | 4,860 | 140 | 4,720 |
| 2022 | 4,451 | 161 | 4,290 |
Long-Term Growth
- The total number of Pennsylvanians living with kidney failure increased by 18% since 2011 (per 2024 report)
- The total number increased by 15% since 2012 (per 2025 report)
Historical Baseline (2012 Snapshot)
- 4,723 patients diagnosed with kidney failure
- 17,234 patients on dialysis
- 8,214 patients with a kidney transplant
- 6,873 patients wait-listed for a kidney transplant
Despite slight year-over-year decreases in new case diagnoses (from 4,918 in 2018 to 4,451 in 2022), the overall population living with kidney failure remains near 30,000 and has grown substantially over the past decade. The gradual decline in dialysis numbers and increase in transplant recipients may reflect modest improvements in transplant access. Still, dialysis remains the primary treatment for the vast majority of new kidney failure patients, with only approximately 3–4% of new cases receiving a transplant at the time of diagnosis.
Kidney Transplant Waiting List and Access
Access to kidney transplants in Pennsylvania remains highly limited, with demand far exceeding supply.
| Metric | 2020 Data | 2023 Data | 2024 Data |
| Patients on waiting list | 6,044 | 5,898 | 5,448 |
| Transplants performed | 1,137 | 1,131 | 1,238 |
| Living donor transplants | — | 377 | 425 |
| Deceased donor transplants | — | 754 | 813 |
| Ratio receiving transplant | ~1 in 5 | ~1 in 5 | ~1 in 4 |
Kidney Transplant Wait Times by Center
Wait times for kidney transplants vary significantly by transplant center. The following data covers Pennsylvania’s transplant centers.
| Transplant Center | Wait Time Forecast (months) | Patients on Waiting List | 2025 Deceased-Donor Transplants |
| Allegheny General Hospital | 32 | 209 | 74 |
| Lehigh Valley Hospital | 35 | 275 | 106 |
| University of Pittsburgh Medical Center | 50 | 556 | 90 |
| Albert Einstein Medical Center | 59 | 460 | 52 |
| Geisinger Medical Center | 74 | 297 | 49 |
| Harrisburg Hospital | 94 | 385 | 40 |
| Hospital of the University of Pennsylvania | 111 | — | — |
Wait times range from a low of 32 months (just under 3 years) at Allegheny General to a high of 111 months (over 9 years) at the Hospital of the University of Pennsylvania.
Additional Key Figures
- 1,238 transplants were performed in Pennsylvania in 2024 — a 25% increase from 2014
- There was a 50% increase in living donor kidney transplants compared to 2014
- More than 6,000 Pennsylvanians are on the transplant waiting list as of August 2025
- 226 patients died while on the waitlist in 2022
- 984 kidney transplants were performed in 2022
While transplant numbers are growing — up 25% over a decade — the waiting list remains long and the supply-demand gap is severe. Only about 1 in 4 to 1 in 5 patients on the waiting list receive a transplant in a given year.
Kidney Cancer
Renal Cell Carcinoma
Renal Cell Carcinoma (RCC) is the primary form of kidney cancer. Pennsylvania has tracked RCC trends extensively through its Cancer Registry.
Statewide Incidence
- Pennsylvania RCC incidence rate (2018): 16.2 per 100,000 population
- Total RCC cases reported in Pennsylvania in 2018: 2,700
- Overall RCC incidence in Pennsylvania nearly doubled over 27 years, from 9.9 per 100,000 (1990) to 18.0 per 100,000 (2017)
- Recent trend (2018–2022): falling at –2.7% per year (95% CI: –4.8, –1.4)
- U.S. rate (2018–2022): 17.5 per 100,000, also falling at –1.0% per year
RCC Incidence Trend by Cancer Site (Age-Adjusted, Pennsylvania)
| Year | Kidney & Renal Pelvis Incidence Rate | Rank Among Top 10 Cancers |
| 2010 | 16.7 per 100,000 | 10th |
| 2017 | 18.0 per 100,000 | 9th |
| % Change | +7.8% | Moved up one rank |
Among the top 10 cancers in Pennsylvania, kidney cancer was one of only three to show an incidence increase from 2010 to 2017:
- Liver and intrahepatic bile duct: +17.8%
- Pancreas: +8.9%
- Kidney and renal pelvis: +7.8%
- Breast cancer: +3.0%
- Melanoma: +2.0%
While recent data (2018–2022) shows kidney cancer incidence is now falling in Pennsylvania — faster than the national rate — the 27-year historical record shows a near-doubling of cases. The current declining trend may reflect improvements in detection and risk factor management, but the disease remains among the top 10 cancers in the state by incidence.
Renal Cell Carcinoma — Patient Characteristics (1990–2017)
A total of 59,628 cases of RCC were recorded in Pennsylvania’s Cancer Registry from 1990 to 2017.
| Variable | Category | Number of Cases | Percent |
| Age | 0–50 years | 8,085 | 13.6% |
| 50+ years | 51,543 | 86.4% | |
| Gender | Female | 23,170 | 38.9% |
| Male | 36,457 | 61.1% | |
| Race | Caucasian | 52,959 | 88.8% |
| Black | 5,659 | 9.5% | |
| SEER Stage at Diagnosis | In Situ | 975 | 1.6% |
| Local | 37,264 | 62.5% | |
| Regional | 9,887 | 16.6% | |
| Distant | 9,439 | 15.8% |
Annual Percentage Change (APC) in RCC incidence, 1990–2017
- Overall: +2.32%
- Local stage: +3.23%
- Regional stage: +1.00%
- Distant stage: +0.23% (not statistically significant)
- Age under 50: +3.8%
- Age 50+: +2.0%
- Male: +2.25%
- Female: +2.09%
- African American: +2.72%
- Caucasian: +2.33%
The 27-year RCC data reveals several important patterns. The disease is heavily concentrated in older patients (86.4% over age 50) and is more common in males (61.1%). Encouragingly, the increase in incidence has been driven primarily by local and regional stage diagnoses — suggesting earlier detection — while distant (metastatic) disease rates remained essentially stable.
Kidney Cancer Incidence by Pennsylvania County (2018–2022)
The following table presents age-adjusted kidney and renal pelvis cancer incidence rates by county, averaged over 2018–2022. Pennsylvania’s overall rate of 16.2 per 100,000 is below the U.S. average of 17.5, and both are on a falling trend.
| County | Urban/Rural | Age-Adjusted Rate (per 100,000) | Avg. Annual Count | Recent Trend |
| Pennsylvania (total) | — | 16.2 | 2,773 | Falling (–2.7%) |
| US (SEER+NPCR) | — | 17.5 | 70,592 | Falling (–1.0%) |
| Greene County | Rural | 24.5 | 12 | Stable |
| Columbia County | Rural | 23.5 | 21 | Rising (+3.6%) |
| Carbon County | Urban | 22.5 | 21 | Stable |
| Montour County | Rural | 22.3 | 6 | Stable |
| Elk County | Rural | 21.9 | 10 | Stable |
| Fayette County | Urban | 21.6 | 39 | Stable |
| Bedford County | Rural | 21.5 | 15 | Stable |
| Tioga County | Rural | 21.2 | 12 | Rising (+3.7%) |
| Blair County | Urban | 20.5 | 35 | Stable |
| Monroe County | Rural | 19.7 | 44 | Rising (+3.8%) |
| Cambria County | Urban | 19.6 | 37 | Stable |
| Clearfield County | Rural | 19.4 | 23 | Stable |
| Clarion County | Rural | 19.3 | 10 | Stable |
| Luzerne County | Urban | 19.2 | 87 | Rising (+1.3%) |
| Washington County | Urban | 19.1 | 57 | Stable |
| Wyoming County | Urban | 19.1 | 8 | Stable |
| Northampton County | Urban | 18.8 | 80 | Stable |
| Juniata County | Rural | 18.7 | 7 | Stable |
| Erie County | Urban | 18.0 | 63 | Stable |
| Lackawanna County | Urban | 18.0 | 52 | Stable |
| Schuylkill County | Rural | 18.2 | 36 | Stable |
| Mifflin County | Rural | 18.1 | 11 | Stable |
| Jefferson County | Rural | 17.9 | 11 | Stable |
| Bradford County | Rural | 17.5 | 15 | Falling (–14.8%) |
| Warren County | Rural | 17.5 | 10 | Stable |
| Somerset County | Rural | 17.6 | 20 | Rising (+3.0%) |
| Susquehanna County | Rural | 17.4 | 11 | Rising (+3.1%) |
| Lycoming County | Urban | 17.2 | 27 | Rising (+2.4%) |
| Lehigh County | Urban | 17.1 | 79 | Stable |
| Berks County | Urban | 16.9 | 90 | Stable |
| Franklin County | Urban | 16.5 | 34 | Stable |
| Bucks County | Urban | 16.5 | 148 | Stable |
| Snyder County | Rural | 16.4 | 9 | Stable |
| Philadelphia County | Urban | 16.3 | 282 | Falling (–4.8%) |
| Venango County | Rural | 16.2 | 12 | Stable |
| Centre County | Urban | 16.2 | 27 | Stable |
| Huntingdon County | Rural | 16.2 | 10 | Rising (+3.2%) |
| Dauphin County | Urban | 16.0 | 59 | Stable |
| Lebanon County | Urban | 15.8 | 30 | Falling (–6.6%) |
| Westmoreland County | Urban | 15.6 | 84 | Stable |
| Armstrong County | Urban | 15.6 | 16 | Stable |
| Wayne County | Rural | 15.6 | 14 | Stable |
| McKean County | Rural | 15.2 | 8 | Stable |
| Crawford County | Rural | 14.9 | 19 | Stable |
| Clinton County | Rural | 14.8 | 8 | Stable |
| Butler County | Urban | 14.5 | 39 | Falling (–12.8%) |
| Montgomery County | Urban | 14.5 | 162 | Stable |
| Northumberland County | Rural | 14.4 | 18 | Stable |
| York County | Urban | 14.3 | 84 | Falling (–1.8%) |
| Lancaster County | Urban | 14.0 | 100 | Stable |
| Pike County | Rural | 14.0 | 14 | Stable |
| Cumberland County | Urban | 13.9 | 48 | Stable |
| Adams County | Urban | 13.5 | 20 | Stable |
| Indiana County | Rural | 13.1 | 15 | Stable |
| Mercer County | Rural | 12.8 | 22 | Falling (–8.6%) |
| Chester County | Urban | 12.6 | 87 | Falling (–7.7%) |
| Potter County | Rural | 12.6 | 3 | — |
| Allegheny County | Urban | 15.7 | 259 | Falling (–1.0%) |
| Delaware County | Urban | 15.3 | 107 | Falling (–7.7%) |
Cameron, Forest, Fulton, and Sullivan counties: fewer than 3 cases; data suppressed.
Greene County has the highest age-adjusted kidney cancer incidence rate in Pennsylvania at 24.5 per 100,000, while Chester County and Potter County share among the lowest at 12.6 per 100,000.
Kidney Cancer Death Rates by Pennsylvania County (2019–2023)
Pennsylvania’s overall age-adjusted kidney cancer death rate of 3.3 per 100,000 is slightly better than the U.S. average of 3.4, and the trend is falling. The following lists the counties from highest to lowest death rate.
downward.
| County | Urban/Rural | Age-Adjusted Death Rate (per 100,000) | Avg. Annual Count | Recent Trend |
| Pennsylvania | — | 3.3 | 600 | Falling (–1.3%) |
| United States | — | 3.4 | 14,378 | Falling (–1.4%) |
| Greene County | Rural | 6.6 | 3 | Stable |
| Armstrong County | Urban | 5.5 | 6 | Rising (+33.2%) |
| Venango County | Rural | 4.8 | 4 | Stable |
| Northumberland County | Rural | 4.6 | 7 | Stable |
| Warren County | Rural | 4.6 | 3 | — |
| Bedford County | Rural | 4.5 | 4 | Stable |
| Crawford County | Rural | 4.2 | 5 | Stable |
| Westmoreland County | Urban | 4.2 | 25 | Stable |
| Beaver County | Urban | 4.2 | 12 | Stable |
| Lycoming County | Urban | 4.2 | 7 | Stable |
| Erie County | Urban | 4.2 | 16 | Stable |
| Clearfield County | Rural | 4.2 | 5 | Stable |
| Fayette County | Urban | 4.1 | 8 | Stable |
| Lebanon County | Urban | 4.1 | 9 | Stable |
| Mercer County | Rural | 4.0 | 8 | — |
| Monroe County | Rural | 3.9 | 9 | Stable |
| Bradford County | Rural | 3.9 | 4 | — |
| Columbia County | Rural | 3.8 | 3 | — |
| Butler County | Urban | 3.8 | 11 | Stable |
| Schuylkill County | Rural | 3.8 | 8 | Stable |
| Adams County | Urban | 3.7 | 6 | Stable |
| Franklin County | Urban | 3.7 | 9 | Stable |
| Blair County | Urban | 3.7 | 7 | Stable |
| Dauphin County | Urban | 3.6 | 14 | Stable |
| Northampton County | Urban | 3.6 | 17 | Stable |
| Berks County | Urban | 3.6 | 20 | Stable |
| Cambria County | Urban | 3.5 | 7 | Falling (–2.0%) |
| Carbon County | Urban | 3.5 | 4 | Falling (–3.7%) |
| Cumberland County | Urban | 3.5 | 13 | Stable |
| Luzerne County | Urban | 3.4 | 17 | Falling (–2.4%) |
| Wayne County | Rural | 3.4 | 3 | — |
| Bucks County | Urban | 3.2 | 31 | Stable |
| York County | Urban | 3.1 | 19 | Falling (–1.9%) |
| Lehigh County | Urban | 3.1 | 15 | Stable |
| Allegheny County | Urban | 3.1 | 56 | Falling (–1.6%) |
| Lackawanna County | Urban | 3.1 | 10 | Stable |
| Washington County | Urban | 3.0 | 10 | Stable |
| Pike County | Rural | 3.0 | 4 | — |
| Somerset County | Rural | 3.0 | 4 | Stable |
| Indiana County | Rural | 3.0 | 4 | Stable |
| Lancaster County | Urban | 2.9 | 23 | Falling (–2.2%) |
| Lawrence County | Urban | 2.9 | 4 | Falling (–2.7%) |
| Philadelphia County | Urban | 2.8 | 48 | Falling (–1.7%) |
| Montgomery County | Urban | 2.8 | 33 | Falling (–1.4%) |
| Delaware County | Urban | 2.5 | 19 | Falling (–2.4%) |
| Centre County | Urban | 2.3 | 4 | Falling (–3.7%) |
| Chester County | Urban | 1.7 | 12 | Falling (–4.0%) |
In general, suburban counties around Philadelphia (Chester, Delaware, Montgomery) and urban centers show the lowest death rates and improving trends, while rural counties tend to have higher rates with less consistent improvement.
Kidney Disease (Nephritis & Nephrosis) Mortality — Pennsylvania
Pennsylvania’s death rate from nephritis and nephrosis (broad kidney disease mortality) is notably higher than the national average.
- Pennsylvania age-adjusted death rate: 16.4 per 100,000 (3,017 average annual deaths)
- U.S. age-adjusted death rate: 13.4 per 100,000 (54,332 average annual deaths)
- Overall kidney disease mortality deaths (2021 report): 3,001 | Death rate: 15.6
Top 10 Counties by Nephritis/Nephrosis Death Rate
| County | Age-Adjusted Rate (per 100,000) | Avg. Annual Count | Recent Trend |
| Blair County | 24.7 | 46 | Rising (+7.4%) |
| McKean County | 23.4 | 14 | — |
| Erie County | 23.2 | 87 | Stable |
| Cambria County | 22.9 | 52 | Stable |
| Potter County | 22.8 | 7 | — |
| Jefferson County | 22.6 | 16 | Stable |
| Clearfield County | 22.4 | 28 | Stable |
| Fulton County | 22.4 | 5 | — |
| Greene County | 22.4 | 11 | — |
| Dauphin County | 21.8 | 79 | Falling (–0.9%) |
Bottom 5 Counties by Nephritis/Nephrosis Death Rate
| County | Age-Adjusted Rate (per 100,000) | Avg. Annual Count | Recent Trend |
| Chester County | 10.7 | 73 | Falling (–2.1%) |
| Northampton County | 10.9 | 54 | Falling (–3.2%) |
| Butler County | 12.0 | 35 | Falling (–1.8%) |
| Union County | 12.1 | 8 | — |
| Pike County | 12.5 | 12 | Stable |
Pennsylvania’s overall kidney disease mortality rate (16.4 per 100,000) is notably higher than the national average of 13.4 — a gap of more than 22%. The geographic disparity — concentrated in rural, central, and western Pennsylvania — points to structural inequalities in healthcare infrastructure.
Medicare Costs for Kidney Disease
The financial burden of kidney disease on Medicare is substantial. The following figures reflect average annual costs per patient.
| Stage of Kidney Disease | Average Annual Medicare Cost |
| Pre-kidney failure (CKD) | $25,920 |
| Dialysis patient | $79,439 |
| First year after transplant | $23,308* |
*Per person per year (2016–2019), of which $6,947 per person per year was for immunosuppressants.
Pennsylvania Medicare Kidney Disease Statistics
- 13,066 Medicare patients on dialysis in Pennsylvania
- 5,934 kidney patients on the transplant waitlist
The cost data reveals a stark financial picture: dialysis costs Medicare more than three times the cost of supporting a post-transplant patient. This reinforces the economic argument, alongside the humanitarian one, for expanding transplant access. The first-year post-transplant cost of $23,308 is also significantly lower than pre-failure CKD management ($25,920), suggesting transplant is cost-effective even in the short term.
Financial Assistance for Pennsylvania Kidney Patients
The American Kidney Fund (AKF) provides critical financial support to low-income kidney patients in Pennsylvania. The following table tracks AKF activity in the state over recent years.
| Year | PA Patients Receiving AKF Grants | Total Charitable Assistance |
| 2020 | 3,017 | $8,600,000 |
| 2023 | 2,137 | $6,683,108 |
| 2024 | 2,151 | $6,534,606 |
Patient Financial Profile and Work Capacity
- Average income of AKF-assisted patients: less than $25,000/year
- Average out-of-pocket costs for dialysis patients: more than $10,000/year
- More than 80% of dialysis patients cannot work
- AKF assistance covers insurance premiums, emergency pandemic-related costs, and other health care-related costs not covered by insurance
Racial Breakdown of AKF-Assisted Patients in Pennsylvania:
- Black: 34.7%
- Hispanic/Latino: 20.9%
- Native American / Asian / Pacific Islander: 5.2%
The financial burden on dialysis patients is severe — with average out-of-pocket costs exceeding $10,000 annually against average incomes below $25,000. The fact that over 80% of patients cannot work makes this gap even more critical. The racial composition of AKF-assisted patients reflects the well-documented disproportionate burden of kidney disease on minority communities.
Conclusion
The data presented in this article paints a sobering picture of kidney disease in Pennsylvania. With nearly one million residents estimated to have CKD — the vast majority unaware of their condition — and close to 30,000 living with kidney failure, the disease places an enormous and largely silent burden on the state’s population and healthcare system. While Pennsylvania fares somewhat better than the national average in certain metrics, such as the rate of growth in CKD disease burden and kidney cancer death rates, it significantly underperforms the U.S. average in others, most notably in broad kidney disease mortality, which runs more than 22% higher than the national figure.
Geographic disparities are among the most striking findings in this dataset. Rural and semi-rural counties — particularly in central, western, and northeastern Pennsylvania — consistently record higher rates of kidney cancer incidence, kidney disease mortality, and rising trends across multiple indicators. Meanwhile, suburban counties in the Philadelphia region and several larger urban centers show lower rates and improving trajectories. This pattern points to deep structural inequalities in healthcare access, preventive care, and early detection that track closely with rurality, and that will require targeted, county-level policy responses rather than one-size-fits-all interventions.
Finally, the human and economic costs of kidney disease in Pennsylvania demand urgent attention. Dialysis costs Medicare nearly $80,000 per patient per year — more than three times the cost of post-transplant care — yet only about 1 in 4 Pennsylvanians on the transplant waiting list receive a kidney in any given year, and 226 patients died waiting in 2022 alone. For patients themselves, the financial toll is equally severe: average out-of-pocket costs exceed $10,000 annually against typical incomes below $25,000, and more than 80% of dialysis patients cannot work. Expanding transplant capacity, improving chronic disease management to prevent progression to kidney failure, and addressing racial and geographic disparities must be central priorities for Pennsylvania’s public health agenda in the years ahead.
Sources:
- Explore Chronic Kidney Disease in Pennsylvania | AHR
- Kidney failure (ESRD) – in Pennsylvania
- Indicators :: Chronic Kidney Disease: Medicare Population :: State : Pennsylvania
- Chronic Disease Burden Report 2021
- Kidney Disease Mortality | Stats of the States | CDC
- Kidney failure
- Kidney failure
- Hill Day Materials — KD by numbers
- State Cancer Profiles
- Kidney Cancer Treatment Pennsylvania | Dr. Shirin Razdan
- Characteristics of patients diagnosed with renal cell carcinoma in the Pennsylvania Cancer Registry from 1990 to 2017
- Incidence and Distribution of New Renal Cell Carcinoma Cases: 27-Year Trends from a Statewide Cancer Registry
- Burden of Chronic Kidney Disease by State from 2002 to 2016 | Docwire News
- Mortality Table for Colorado Counties | HDPulse Data Portal
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- Hospitals, State Leaders Encourage Pennsylvanians to Register as Organ Donors – HAP
- Kidney Transplant Centers in Pennsylvania: Wait Times by Center