Higher incidence of end-stage renal disease (ESRD) found at for-profit dialysis chains. Patients receiving dialysis at facilities owned by large, for-profit kidney dialysis chains have a higher incidence of ESRD in comparison with patients at non profit centers, according to a report published online on December 9, 2010, in Health Services Research. They also had a 13% higher risk of dying. The researchers used data from the U.S. Renal Data System to track the incidence of ESRD in 34,914 Medicare patients at the five largest dialysis chains and two nonchain centers for two years. The findings "suggest that large chain status of a dialysis facility is independently related to patient mortality [rates]," write the researchers. A dramatic increase in the number of large, chain-owned dialysis centers ("more than 11-fold since 1991," according to the authors) raises concerns about quality of care and patient outcomes.

Figure. Cathleen Sharkey holds framed photographs of her mother, Barbara Scott, whose bloodline became disconnected during dialysis treatment. Scott never fully recovered and died shortly after of heart failure. Photo by Dan Nguyen / ProPublica.