Kidney Dialysis Centers NAICS 621492
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Industry Summary
The 8,500 kidney dialysis centers in the US provide dialysis treatment for patients with end stage renal disease (ESRD), also known as chronic kidney failure. Patients with ESRD require dialysis treatments or a kidney transplant to sustain life. Dialysis is the removal of toxins, fluids, and salt from the blood of patients by artificial means.
Dependence on Government Reimbursements
Kidney dialysis centers earn the majority of their revenue through reimbursements from Medicare and Medicaid, since all ESRD patients are covered by Medicare, regardless of their age or financial circumstances.
Recent Developments
Nov 10, 2025 - Pilot Transitional Dialysis Program Cuts Utilization Of Emergency Dialysis
- A transitional dialysis program piloted in Texas resulted in a significant decrease in emergency department visits and hospital admissions for emergency dialysis, according to findings presented at ASN Kidney Week 2025. The cost of emergency dialysis is estimated to be eight times that of in-center dialysis. The pilot program reduced hospital admissions for emergency dialysis primarily by providing a pathway for outpatient dialysis in uninsured patients.
- President Trump has signed into law the $3.4 trillion One Big Beautiful Bill that is estimated by Healio to include $930 billion in Medicaid cuts over 10 years. Kidney dialysis centers earn the majority of their revenue through reimbursements from Medicare and Medicaid. Nearly 12 million more people may be uninsured by 2034, with many losing coverage because of the Medicaid provisions in the bill, according to a US Congressional Budget Office analysis. For the first time in the Medicaid program’s nearly 60-year history, certain able-bodied adults aged 19 years to 64 years will be required to work, participate in job training, volunteer, or enroll in school at least 80 hours a month to maintain their Medicaid benefits. This will also be required for parents of children aged 14 years and older.
- Fewer patients starting dialysis are enrolling in Medicare since the introduction of the Affordable Care Act (ACA) in 2014 and are instead opting for private insurance, according to a study published in in JAMA Health Forum. The ACA expanded access to private insurance by preventing plans from denying coverage because of preexisting conditions, promoting state insurance exchanges, and relaxing special enrollment periods. “Dialysis expenditures for privately insurance patients were at least twice as high as patients with Medicaid who enrolled in Medicare after dialysis initiation and several times higher for patients with Medicaid who did not enroll in Medicare,” the investigators note. “This may lead to unnecessarily high overall societal costs and inequitable access to care for some patients, which ultimately affects payers, patients, and overall consumers (ie, overall consumer health care insurance premiums are not limited to patients with ESKD).”
- Kidney dialysis center industry employment decreased slightly and average wages for nonsupervisory employees increased slightly during the first seven months of 2025, according to the US Bureau of Labor Statistics. Kidney dialysis industry sales are forecast to increase at a 5.75% compounded annual rate from 2025 to 2029, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.
Industry Revenue
Kidney Dialysis Centers
Industry Structure
Industry size & Structure
A typical kidney dialysis center has 15 employees and generates about $3-4 million in revenue.
- The kidney dialysis center industry in the US consists of 507 firms operating about 8,500 centers, employing 129,400 workers, and generating $28.2 billion in annual revenue.
- The industry is highly concentrated, as the two largest firms – Fresenius Medical and DaVita – treat about 80% of kidney dialysis patients in the US and account for 72% of outpatient dialysis centers.
- Other large kidney dialysis firms include US Renal Care, Dialysis Clinic, Inc., American Renal Associates, and Satellite Healthcare.
- There are about 558,000 patients receiving dialysis treatment in the US.
- 85% of US dialysis patients receive hemodialysis treatment, usually at a kidney dialysis center. About 2% receive hemodialysis at home. About 15% of dialysis patients receive peritoneal dialysis, usually at home.
Industry Forecast
Industry Forecast
Kidney Dialysis Centers Industry Growth
Source: Vertical IQ and Inforum
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