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Kidney Disease Statistics in South Carolina, USA

Nearly 15,000 South Carolinians are currently living with kidney failure — a number that has grown by more than 27% over the past decade and continues to rise. The state ranks among the most burdened in the nation for end-stage renal disease, driven largely by high rates of diabetes and hypertension in the general population. In the absence of dialysis or a kidney transplant, kidney failure is fatal.

The toll of kidney disease in South Carolina falls unevenly across racial, economic, and geographic lines. Black residents die from kidney disease at twice the rate of white residents, and minority patients make up the majority of those requiring charitable assistance to afford care. More than 80% of dialysis patients cannot work, yet face out-of-pocket medical costs exceeding $10,000 per year on average incomes below $25,000.

This article draws on data from multiple annual reporting periods to provide a comprehensive statistical picture of kidney disease in South Carolina. It covers disease prevalence and long-term trends, chronic kidney disease, kidney cancer, causes and risk factors, dialysis and transplant activity, clinical outcomes at the state’s only transplant center, mortality, hospital utilization, racial disparities, and the financial assistance landscape for patients.

Chronic Kidney Disease (CKD)

Chronic kidney disease is a progressive condition in which the kidneys lose function over time. It frequently leads to end-stage renal disease (kidney failure) if undetected or poorly managed. South Carolina’s data on CKD prevalence and patient burden point to significant gaps in awareness and early intervention.

5.2% of South Carolina adults report having been told by a health professional that they have kidney disease (excluding kidney stones, bladder infections, and incontinence)
South Carolina ranks 47th among U.S. states on this measure
3,345 South Carolinians on Medicare have been diagnosed with CKD

South Carolina’s CKD prevalence figures point to a significant awareness gap. With only 5.2% of adults self-reporting a diagnosis and the state ranked 47th nationally, a large share of the population likely has undetected kidney disease — a concern given that CKD rarely produces symptoms until it is well advanced.

Kidney Failure Burden and Prevalence

South Carolina has experienced a persistent and substantial rise in kidney failure across all major metrics. The data below tracks the prevalence of kidney failure, its treatment distribution, long-term growth trends, the state’s national standing, and the annual rate of new diagnoses.

Kidney Failure Prevalence Over Time

Report Year	Living with Kidney Failure	On Dialysis	Living with Transplant
2021	13,945	10,610	3,335
2023	14,386	10,661	3,725
2024	14,117	10,273	3,844
2025	14,372	10,267	4,105
2026	14,796	10,321	4,475

National Rankings

Metric	SC Rate (per 100,000)	National Rank
ESRD prevalence rate (2012)	240.6	6th highest in the U.S.
Diabetes-attributable ESRD prevalence rate (2012)	87.1	9th highest in the U.S.

New Kidney Failure Diagnoses

New case data in each annual report typically reflects diagnoses from approximately two years prior.

Diagnosis Year	New Cases	Received Transplant	Began Dialysis
2018	2,373	55	2,318
2020	2,409	57	2,352
2021	2,456	61	2,395
2022	2,504	79	2,425
2023	2,546	86	2,460

The long-term trend is unambiguous — kidney failure in South Carolina has grown by 27–38% over the past decade depending on the baseline year. The number of patients living with transplants has been rising steadily, but the large majority still rely on dialysis. South Carolina’s high ESRD national rankings point to a state with both elevated disease burden and significant public health challenges.

Causes and Risk Factors

Diabetes and high blood pressure together account for the large majority of kidney failure cases in South Carolina, and both are widespread in the general population.

Leading Causes of Kidney Failure

Report Year	Diabetes	High Blood Pressure
2023	47%	30%
2024	44%	29%
2025	44%	29%
2026	43%	30%

Population Risk Factors

The following risk factors, measured in 2021, reflect the scale of underlying vulnerability in South Carolina’s population.

Have high blood pressure: 38.3%
Self-report as obese: 35.4%
Diagnosed with diabetes: 13.4%

Diabetes has consistently been the leading driver of kidney failure in South Carolina, though its reported share has declined slightly from 47% to 43% in recent years. High blood pressure remains a steady second cause. With more than a third of the state population obese and nearly 40% hypertensive, South Carolina’s underlying risk profile strongly suggests continued upward pressure on kidney disease rates for years to come.

Kidney Cancer in South Carolina

Kidney and renal pelvis cancer is tracked separately from kidney failure. South Carolina’s overall cancer incidence rates are close to national averages, but county-level data reveals marked variation across the state.

County-Level Late-Stage Cancer Incidence (2018–2022)

Age-adjusted incidence rates per 100,000 population. The late-stage percentage indicates the share of all cases diagnosed at an advanced stage — a proxy for early detection access.

County	Setting	Incidence Rate (per 100,000)	Avg. Annual Count	Late-Stage Cases (%)
Greenwood County	Rural	9.2	9	37.6%
Pickens County	Urban	7.2	11	34.3%
Oconee County	Rural	7.1	9	32.3%
Colleton County	Rural	7.1	3	25.8%
Laurens County	Urban	6.8	6	38.3%
Newberry County	Rural	6.5	4	34.6%
Anderson County	Urban	6.1	16	33.9%
Sumter County	Urban	6.0	8	38.7%
Lexington County	Urban	5.7	21	30.3%
Spartanburg County	Urban	5.7	23	30.5%
Orangeburg County	Rural	5.6	7	30.3%
Cherokee County	Rural	5.5	3	27.9%
Charleston County	Urban	5.2	27	28.4%
Florence County	Urban	5.2	9	26.1%
Kershaw County	Urban	5.2	5	25.5%
Georgetown County	Rural	5.1	5	25.5%
Lancaster County	Urban	4.7	7	31.1%
Greenville County	Urban	4.6	30	24.7%
Richland County	Urban	4.5	20	26.0%
Horry County	Urban	4.4	26	24.0%
Dorchester County	Urban	4.3	8	22.1%
Beaufort County	Urban	4.2	13	34.4%
York County	Urban	4.2	14	30.3%
Aiken County	Urban	4.2	10	30.5%
Berkeley County	Urban	3.6	9	19.7%
South Carolina	—	4.9	333	27.9%
United States	—	5.0	20,556	29.1%

Greenwood County has the highest late-stage kidney cancer incidence rate at 9.2 per 100,000 — nearly double the state average. Rural counties are disproportionately represented at the top of this list (Greenwood, Oconee, Colleton, Newberry, Cherokee), which likely reflects reduced access to screening and early-stage detection. Sumter County has the highest proportion of late-stage diagnoses (38.7%), while Berkeley County has both the lowest incidence rate (3.6) and the lowest late-stage proportion (19.7%). South Carolina’s overall rate (4.9) is marginally below the national figure (5.0), and its late-stage proportion (27.9%) compares slightly favorably to the national average (29.1%).

Dialysis Statistics in South Carolina

Dialysis is the dominant treatment modality for South Carolina kidney failure patients, accounting for more than 74% of those currently living with the disease.

Dialysis Statistics Over Time

Year	Patients on Dialysis (Prevalence)	New Dialysis Cases (Incidence)	Dialysis Patient Deaths
2010	7,820	1,924	1,480
2011	7,977	1,809	1,406
2012	8,284	1,933	1,394
2013	8,659	2,023	1,445
2014	9,152	2,073	1,389

Key Facts About Dialysis Patients

The total number of South Carolinians on dialysis increased by 15% in the five years from 2010 to 2014
Deaths among dialysis patients fell from 1,480 in 2010 to 1,389 in 2014, even as the patient population grew
More than 80% of dialysis patients are unable to work — dialysis and its comorbidities are treated as a disability

The five-year dialysis data shows consistent growth in the patient population, with prevalence rising by approximately 1,000 patients every two years. The slight decline in deaths despite a growing patient base suggests some improvement in treatment quality over this period. However, the fact that more than four in five patients cannot work underscores the severity of the condition and its socioeconomic consequences.

Kidney Transplantation Statistics

Transplant volumes in South Carolina have grown dramatically over the past decade, though demand continues to outpace supply.

Annual Transplant Activity

Activity Year	Total Transplants	Living Donor	Deceased Donor	Patients on Waiting List
2020	350	—	—	1,229
2022	478	62	416	1,470
2023	531	63	468	1,531
2024	607	82	525	1,623
2025	653	79	574	1,849

Long-Term Growth in Transplant Volume

Total Transplant Activity

2025 vs. 2015: +200%
2024 vs. 2014: +210%
2023 vs. 2013: +193%
2022 vs. 2012: +150.3%

Living Donor Transplants Specifically

2025 vs. 2015: +155%
2024 vs. 2014: +204%
2023 vs. 2013: +163%
2022 vs. 2012: +129.6%

Additional context: Approximately 1 in 3 waitlisted patients received a transplant in 2022 (per 2023 data).

The tripling of annual transplants since the early 2010s is among the most significant positive developments in South Carolina kidney care. Living donor transplants have grown especially fast, with some comparison periods showing more than a 200% increase. Despite this progress, the waiting list has grown from 1,229 in 2020 to 1,849 in 2026, meaning demand is rising faster than capacity. With 1,849 patients waiting and 653 transplants performed in 2025, well over 1,000 patients remained without a transplant by year’s end.

South Carolina’s Transplant Center: MUSC

South Carolina has one kidney transplant center: the Medical University of South Carolina (MUSC) in Charleston, which handles all kidney transplant activity in the state.

Recipient Program Metrics (Prior Year: 04/01/2025 – 03/31/2026)

Metric	Value
NKR Transplants (Last 12 Months)	1
NKR Living Donor Transplants (Prior Year)	3
Total Living Donor Transplants (Prior Year)	65
NKR % of Living Donor Transplants	5%
Low Eplet Transplants (Last 12 Months)	0
Patient Microsites	No
Microsite Center of Excellence	No

As the sole kidney transplant center in South Carolina, MUSC bears the full weight of the state’s transplant needs. Its participation in the National Kidney Registry is minimal — just one NKR transplant in the last 12 months — and it has not enrolled in any of the major NKR donor or recipient programs. This limited engagement with national exchange networks may constrain the range of matching opportunities available to South Carolina patients, particularly those who might benefit from paired exchange or remote donation arrangements.

Transplant Outcomes at MUSC

Graft survival refers to the transplanted kidney continuing to function; patient survival refers to the recipient remaining alive.

Adult Outcomes

65 living donor transplants were performed in the prior year.

Outcome Measure	1-Year Rate	3-Year Rate
Living Donor – Graft Survival	95%	91%
Living Donor – Patient Survival	97%	95%
Deceased Donor – Graft Survival	93%	84%
Deceased Donor – Patient Survival	97%	90%

Pediatric Outcomes

Living Donor Transplants

1-Year Graft Survival: 100%
3-Year Graft Survival: 75%
1-Year Patient Survival: 100%
3-Year Patient Survival: 75%

Deceased Donor Transplants

1-Year Graft Survival: 90%
3-Year Graft Survival: 100%
1-Year Patient Survival: 100%
3-Year Patient Survival: 100%

Adult outcomes at MUSC are strong at one year, with patient survival reaching 97% regardless of donor type. Three-year graft survival is notably lower for deceased donor kidneys (84%), which aligns with national patterns of higher long-term graft loss from deceased donors. Pediatric outcomes show perfect one-year rates across all categories, but a notable drop in three-year living donor survival (75%). These pediatric figures may be influenced by small case volumes. The deceased donor pediatric outcomes show an unusual pattern — 90% one-year graft survival rising to 100% at three years — which would typically reflect a small cohort.

Mortality Statistics

Kidney disease is a leading cause of death in South Carolina, and the state’s death rate consistently exceeds the national average.

Kidney & Renal Pelvis Death Rates (2019–2023)

Metric	South Carolina	United States
Age-Adjusted Death Rate (per 100,000)	3.6	3.4
Average Annual Deaths	244	14,378
Recent 5-Year Trend	Falling (–1.0% per year)	Falling (–1.4% per year)

Nephritis & Nephrosis Rates and Additional Historical Context

South Carolina age-adjusted death rate (Nephritis & Nephrosis, 2019–2023): 14.8 per 100,000
United States age-adjusted death rate (Nephritis & Nephrosis, 2019–2023): 13.4 per 100,000
In 2013, 868 people died from kidney disease in South Carolina; the age-adjusted mortality rate had fallen from 19.8 per 100,000 in 2010 to 16.0 per 100,000 in 2013, yet remained above the national rate

Comparison with Other Causes of Death

Age-adjusted rates per 100,000 population, 2019–2023.

Cause of Death	SC Rate	U.S. Rate
Heart Disease	181.8	168.9
Cancer	156.8	145.4
Accidents & Adverse Effects	81.3	59.7
Cerebrovascular Diseases	46.4	39.8
Chronic Lower Respiratory Disease	42.5	35.9
Alzheimer’s Disease	40.6	30.8
Diabetes Mellitus	26.2	23.9
Chronic Liver Disease & Cirrhosis	15.6	13.1
Suicide & Self-Inflicted Injury	15.6	13.9
Kidney Disease (Nephritis & Nephrosis)	14.8	13.4
Septicemia	13.6	10.0
Homicide & Legal Intervention	12.3	7.6
Pneumonia	9.5	10.7
Influenza	1.3	1.1

South Carolina exceeds the national kidney disease death rate by nearly every measure. While the long-term trend is encouraging — rates fell from nearly 20 per 100,000 in 2010 to around 14–16 in recent years — the state is improving more slowly than the national average. With kidney disease ranking as the 8th leading cause of death and South Carolina exceeding the U.S. rate for virtually every major cause of death in the table above, the state faces a broad mortality challenge in which kidney disease is a significant contributor.

County-Level Kidney & Renal Pelvis Death Rates (2019–2023)

Age-adjusted death rates per 100,000 population. Counties with fewer than four average annual deaths are listed with trend data where available.

County	Setting	Death Rate (per 100,000)	Avg. Annual Deaths	Recent 5-Year Trend
Florence County	Urban	4.9	8	Stable (+0.1%)
Darlington County	Urban	4.8	4	Insufficient data
Laurens County	Urban	4.5	4	Insufficient data
Greenwood County	Rural	4.5	4	Stable (+0.3%)
Spartanburg County	Urban	4.3	18	Stable (–0.1%)
Richland County	Urban	4.1	17	Stable (–0.6%)
Kershaw County	Urban	4.0	4	Stable (+0.1%)
Sumter County	Urban	3.9	5	Stable (–0.8%)
York County	Urban	3.8	13	Stable (–0.1%)
Pickens County	Urban	3.7	6	Stable (–2.6%)
Lexington County	Urban	3.7	14	Stable (–1.9%)
Horry County	Urban	3.6	22	Stable (–1.2%)
Charleston County	Urban	3.4	17	Falling (–1.9%)
Beaufort County	Urban	3.1	11	Stable (–0.3%)
Orangeburg County	Rural	3.0	4	Insufficient data
Berkeley County	Urban	3.0	8	Stable (–2.1%)
Greenville County	Urban	3.0	19	Falling (–1.6%)
Aiken County	Urban	2.8	7	Stable (–0.6%)
Oconee County	Rural	2.7	4	Falling (–5.5%)
Lancaster County	Urban	2.6	4	Insufficient data
Anderson County	Urban	2.6	8	Falling (–4.1%)
Dorchester County	Urban	2.3	5	Falling (–4.1%)
South Carolina	—	3.6	244	Falling (–1.0%)
United States	—	3.4	14,378	Falling (–1.4%)

Florence County (4.9) and Darlington County (4.8) have the highest kidney cancer death rates in South Carolina — each more than twice the rate of the lowest county, Dorchester (2.3). Several counties show statistically significant declining trends, most notably Oconee (–5.5%), Anderson (–4.1%), and Dorchester (–4.1%). Counties at the upper end of the table — Florence, Kershaw, Greenwood — show either no trend data or stable rates with slight upward tendencies, suggesting limited recent progress. No county shows a confirmed rising trend. South Carolina’s overall rate (3.6) marginally exceeds the national figure (3.4), and the state is improving slightly more slowly than the national trend.

Healthcare Utilization

Kidney disease generates a substantial burden on South Carolina hospitals and emergency departments. The figures below reflect 2014 data for conditions classified under Nephrosis.

Hospital Utilization

Hospital discharges with Nephrosis as primary diagnosis: 10,010
Hospitalizations with Nephrosis as primary or secondary diagnosis: 103,063
Total hospital charges (primary diagnosis only): Over $343 million

Emergency Department Utilization

1,812 ED visits for Nephrosis as the primary diagnosis in 2014

The scale of kidney disease-related hospital activity is striking — more than 100,000 hospitalizations annually when Nephrosis appears as any diagnosis, and over $343 million in charges for primary-diagnosis cases alone. ED utilization, while lower in absolute volume, points to continued acute demand for kidney-related emergency care across the state.

Financial and Insurance Impact

Kidney failure is economically devastating for most patients. The American Kidney Fund (AKF) provides charitable grants to help low-income dialysis and transplant patients afford insurance premiums and other health care costs not covered by insurance, while Medicare serves as the primary payer for most kidney failure patients nationwide.

AKF Charitable Assistance

Annual Grants to South Carolina Patients

Year	SC Recipients	Total Assistance
2020	1,722	$4,300,000
2022	1,272	$3,689,466
2023	1,116	$3,269,088
2024	1,323	$3,042,158
2025	1,283	Not reported

Financial Hardship Facts

More than 80% of dialysis patients cannot work
Average annual income of patients AKF helps: under $25,000
Average annual out-of-pocket cost for dialysis patients: over $10,000
Out-of-pocket costs thus consume more than 40% of the average AKF-assisted patient’s income

AKF assistance has reached well over 1,000 South Carolinians every year, though both recipient counts and total grant amounts have fluctuated. The financial picture for individual patients is severe: a population earning less than $25,000 annually faces healthcare costs exceeding $10,000 — a burden that is unmanageable without external support. The modest decline in total assistance in recent years may reflect shifts in grant program structure rather than reduced need, given the concurrent rise in kidney failure prevalence.

Racial Breakdown of AKF Assistance Recipients

Black: 34.7%
Hispanic / Latino: 20.9%
Native American / Asian / Pacific Islander: 5.2%

Minority South Carolinians, and Black residents in particular, bear a disproportionate burden of financial hardship.

Insurance Coverage Among AKF Assistance Recipients

The data below show the types of insurance held by South Carolinians who received AKF charitable premium assistance across three reporting years.

2024

Medigap: 27.3%
Medicare Part B: 25.0%
Commercial Employer Group Plans (incl. COBRA): 20.1%
Medicare Advantage: 0.6%

2023

Medicare Part B: 44.6%
Medigap: 23.4%
Employer Group Health Plans (incl. COBRA): 17.2%
Medicare Advantage: 1.4%

2022

Medicare Part B: 40.9%
Medigap: 27.2%
Commercial Employer Group Plans (incl. COBRA): 17.7%
Medicare Advantage: 1.3%

Medicare-related coverage — including both Part B and Medigap — consistently accounts for the largest share of AKF recipients, reflecting the fact that kidney failure patients qualify for Medicare regardless of age under ESRD rules. The notable shift in the 2024 data, where Medicare Part B dropped from roughly 41–45% to just 25% while Medigap rose to 27.3% and commercial coverage rose to 20.1%, may reflect shifts in plan enrollment trends or changes in AKF grant program eligibility. Commercial employer coverage accounting for 17–20% of recipients in all three years confirms that even employed or recently employed patients face unaffordable health care costs.

Medicare Data

The figures below represent Medicare-specific patient counts and cost data, reflecting a reporting period centered around 2016.

Medicare Patient Counts in South Carolina

Patients on Medicare diagnosed with CKD: 3,345
Patients on dialysis: 8,690
Patients with a kidney transplant: 4,176
Patients on the transplant waitlist: 916
Transplants performed in 2016: 177
Patients who died while on the waitlist in 2016: 41

Average Annual Costs to Medicare

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

The cost differential between dialysis and transplant is among the most compelling arguments for expanding transplant access. Medicare pays approximately $85,979 per dialysis patient per year, compared to $32,586 for a transplant patient after the first year — a savings of over $53,000 per patient annually. Scaled across thousands of patients, the financial case for transplantation is immense. Beyond economics, the human cost of the organ shortage is reflected in the 41 patients who died while on the waiting list in 2016 alone.

Conclusion

South Carolina’s kidney disease burden is large, persistent, and growing. Nearly 15,000 residents live with kidney failure today — a figure that has risen by more than a third since 2010 — and more than 2,500 new cases are diagnosed each year. The state consistently exceeds national averages for ESRD prevalence and kidney disease mortality, and its population risk profile — with high rates of diabetes, high blood pressure, and obesity — points toward continued pressure on these numbers without sustained intervention.

There are genuine signs of progress. Kidney transplants in South Carolina have roughly tripled since the early 2010s, with living and deceased donor volumes both rising substantially. Age-adjusted death rates from kidney cancer are on a falling trajectory at the state level and in multiple counties, and the number of patients living with a functioning transplant has increased steadily each year. Clinical outcomes at MUSC, the state’s sole transplant center, are strong, particularly in the first year post-transplant.

Significant structural challenges remain. The transplant waiting list has grown alongside transplant volume, reaching 1,849 patients in 2026, and MUSC’s limited participation in national kidney exchange programs may constrain matching opportunities for South Carolina patients. Racial disparities in mortality and emergency care utilization are pronounced, and the financial burden on patients — most of whom cannot work and face out-of-pocket costs consuming more than 40% of their income — is severe. Expanding transplant access, strengthening preventive care for high-risk communities, and sustaining financial support for patients managing this demanding condition are among the most pressing needs.