The number of people waiting for a kidney transplant in Wales has risen by more than 50% in the last six years, the Kidney Wales Foundation has said.
Kidney dialysis costs around £25,000 per year per patient
Its figures also show there were 431 people on the transplant waiting list at the end of 2007 but only 89 transplants were carried out last year.
The charity said the rise is due to increasing levels of diabetes, heart disease and an ageing population.
The figures were released on the same day a kidney unit opens in west Wales.
The transplant waiting list rise in Wales compares with a 42% increase across the UK.
Kidney Wales Foundation said up to 10,000 people in Wales were now suffering from some kind of chronic kidney disease and these figures were rising.
People with chronic kidney disease are 10 times more likely than healthy individuals to die of heart attacks and strokes.
Allison John of the foundation said better prevention and early detection was needed in Wales, including screening for at all at risk groups.
She also urged people to join the organ donation register.
"These figures are shocking and reveal the public health threat we are facing in Wales," she said.
"They are especially worrying as the numbers diagnosed with renal failure are likely to increase dramatically again over the next decade with the rise in obesity and the linked problems of diabetes and heart disease.
"There is also a desperate shortage of donors in Wales and sadly since 2003 more than 100 people have died before getting that second chance a kidney transplant could have given them."
Dr Richard Moore, clinical director of nephrology and transplantation at the University Hospital of Wales, Cardiff, said Health Minister Edwina Hart seemed to have prioritised renal services.
Meriel Tobin is waiting for a kidney transplant
He said a new transplant centre was being built in Cardiff which would be open in two years.
But treatment was costly, he said.
"A patient needing dialysis is about £25,000 per year," he said.
"A functioning transplant is about £20,000 in the first year but then only £5,000 each year there after."
Meriel Tobin from Port Talbot, who has been waiting for a kidney and pancreas transplant for almost three months and has been on kidney dialysis for a year, said there were many people like her who were waiting for treatment.
"One of the things I have become painfully aware of as an outpatient with the renal unit is just how many people there are waiting for kidneys and they come from all walks of life," she said.
"They are old, young, all sorts of people that you would walk past and see every day on the street and not realise that they have kidney failure or they are on dialysis."
Ms Hart will open the £4m dialysis unit at West Wales General Hospital, Carmarthen later.
The new unit will provide approximately 26 dialysis stations, rising to 30 over time and will allow more patients in the region to be treated locally rather than having to travel long distances.
The unit will eventually replace a dilapidated building first condemned by inspectors in 2004.