Kidney Dialysis Centers

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.

Steady Rate of Home Dialysis

While hemodialysis at a dialysis center is still the predominant form of ESRD treatment, home dialysis treatment has increased in recent years.

Sep 9, 2026 - Pig Kidney Functions For Record 271 Days Inside Man Awaiting Human Transplant

• A man who lived with a pig kidney for 271 days before later receiving a human organ shows how the practice of xenotransplantation could help bridge the gap for patients on the donor list, according to research published in The Lancet. Tim Andrews received a genetically modified pig kidney transplant in January 2025. The pig organ transplant allowed Andrews to skip dialysis for 271 days before he had the organ removed because its function was decreasing. Andrews resumed dialysis before receiving a human kidney transplant in January 2026.
• States need more time to comply with new Medicaid requirements, according to a report from the Center on Budget and Policy Priorities think tank. Many Medicaid expansion enrollees must document at least 80 hours per month of work or similar activities, meet an income threshold, or qualify for an exemption to keep coverage under the new requirements. Fewer patients with end-stage kidney disease died within a year of starting dialysis in states that expanded Medicaid coverage in the wake of the Affordable Care Act, according to Brown University researchers. States face a tight timeline to comply with complex eligibility, reporting, and verification processes before the requirements take effect on January 1, 2027. The Congressional Budget Office estimates that millions of people could lose coverage not because they fail to meet requirements, but because they struggle to navigate reporting systems or encounter administrative barriers. Without more time and clearer federal guidance, the report argues, states risk deploying aging or overburdened systems that are not fully ready.
• 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 increased slightly and average wages for nonsupervisory employees decreased slightly during the first five months of 2026, according to the US Bureau of Labor Statistics. Kidney dialysis industry sales are forecast to increase at a 5.72% compounded annual rate from 2026 to 2030, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.

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 557,000 patients receiving dialysis treatment in the US.
• 84% of US dialysis patients receive hemodialysis treatment, usually at a kidney dialysis center. About 15% of dialysis patients receive peritoneal dialysis, usually at home, according to The National Forum of ESRD Networks.