For the 240,000 rural Americans with complete kidney failure, it’s likely that very few knew they even had kidney disease. According to the Centers for Disease Control and Prevention, kidney disease is usually silent; 90% of people with kidney disease don’t know they have it. With research pointing to the high costs of kidney disease for pediatric and adult patients alike — mostly covered by Medicare — experts and researchers discuss rural disparities around access to disease-stabilizing treatment and to renal replacement therapies.