Mississippi Administrative Code
Title 15 - Mississippi Department of Health
Part 8 - Office of Health Policy and Planning
Subpart 90 - Planning and Resource Development
Chapter 07 - Other Health Services
Section 15-8-90-07-704 - End Stage Renal Disease

End stage renal disease (ESRD) describes the loss of kidney function from chronic renal failure to the extent that the remaining kidney function will no longer sustain life. The kidney's function of filtering waste products from the blood and removing fluid and salts from the body is essential for life; consequently, if untreated, end stage renal disease results in death.

ESRD treatment generally consists of either a kidney transplant or dialysis. Dialysis treatment consists of either peritoneal dialysis or hemodialysis. Peritoneal dialysis, uses a dialyzing fluid which is placed in the abdominal cavity through a plastic tube (catheter), and waste products (fluid and salts) exchange across the peritoneal membrane between the patient's blood and the dialyzing fluid. Hemodialysis is the process by which an artificial kidney machine "washes" metabolic waste products from the bloodstream and removes fluids and salts.

Both hemodialysis and peritoneal dialysis mimic the function normally performed by the kidney. Dialysis can be done by the patient and an assistant in the home, in a facility, or by professional staff in a hospital or limited care facility. Mississippi has sixty-two (62) ESRD facilities and twenty-two (22) Satellite ESRD facilities providing maintenance dialysis services as of FY 2020. Map 7-1 shows the facility locations and Table 7-4 shows the number of existing and CON approved ESRD facilities by county.

Kidney transplantation is the treatment of choice for most patients with end stage renal failure. Unfortunately, suitable kidneys will probably never be available in the number that would be required to treat everyone with this mode of therapy. In kidney transplantation, a healthy kidney is removed from a donor and placed into an ESRD patient. Donors for kidney transplantation may come either from a close relative, such as a sibling or parent, or from an emotionally connected donor, such as a spouse or close associate. Kidneys may also be obtained from cadaver donors who have the closest matching tissue type. Living donors are preferred because they function longer than cadaver kidneys - thirty (30) years for a living donor versus fifteen (15) years for a cadaver kidney.

The University of Mississippi Medical Center, the only kidney transplant program in the state, performed 114 cadaver and eleven (11) living-donor transplants during the calendar year 2020. It is certified by membership in the Organ Procurement and Transplant Network (OPTN) as managed by the United Network of Organ Sharing, a private agency under contract from the Health Resources and Services Administration. Transplant results are comparable to those with transplant programs with similar population basis and can be viewed on the Internet under the Scientific Registry for Transplant Recipients (SRTR) website at www.srtr.org. Approximately, seventy-five (75) additional transplants in Mississippi residents are performed in neighboring states.

Table 7-4

Number of Existing and CON Approved ESRD Facilities by County

FY 2020 Annual ESRD Dialysis Utilization Survey Conducted June 2021

*Satellite ESRD Facility

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