Posetta Mayo sits in her sunroom, lamenting the roses that need tending outside her window while looking at the surgically created clump under the skin of her left arm.
The roses have to wait, and so does she. Mayo's name just got added to the long list of people in Tennessee needing a kidney transplant. The mass on her arm is a fistula, an access point for dialysis. She had worried about a stroke after being diagnosed with high blood pressure, never realizing the threat to her kidneys.
"A simple blood test at random found this," Mayo said. "At that point, my kidneys were working at 19 percent. I'm checked every few months. Now, we're down to 13 percent."
The Dickson County woman battled weight and high blood pressure for years. Now, at age 64, she's about to start dialysis. She's lost her appetite, suddenly dropping pounds and feeling fatigued. But the worst part of it is she knows time is not on her side.
New cases of people diagnosed with kidney failure have more than doubled in Tennessee, increasing from 1,078 in 1990 to 2,574 by 2009, according to federal figures. The supply of kidneys isn't keeping pace with the people who need transplants, and taxpayers are having to pick up the tab.
Researchers attribute the leap to rising rates of diabetes and high blood pressure - conditions that slowly destroy the kidneys without warning signs and often go hand in hand with being overweight. Among diabetics in this state, the incidence rate tripled over the same period of time.
More recent figures provided by BlueCross BlueShield of Tennessee indicate the problem is not going away. The insurer had 11,032 people with kidney failure on its rolls last year, compared with 8,967 the prior year.
But the largest expense is borne by Medicare, which spent $23.3 billion on patients with kidney failure - 8 percent of its total costs - according to the 2011 United States Renal Data System annual report.
The numbers may be alarming, but they should not be a surprise, given the obesity epidemic, said Dr. David Reagan, chief medical officer for the state Health Department.
"Two-thirds of our adult population and one-third of our children in this state are overweight or obese," Reagan said. "It's an extraordinarily widespread problem."
Gov. Bill Haslam's Health and Wellness Task Force has made the state's obesity epidemic its primary focus and is convening community leaders to devise an action plan. The link between being overweight and developing kidney disease is one of the many health consequences of obesity, but Reagan said people do not understand the magnitude of this particular condition.