U.S. Dialysis Services Market Size, Share & Industry Analysis, By Dialysis Type (Hemodialysis and Peritoneal Dialysis), By End-user (Dialysis Centers, Home Healthcare, and Hospitals), By Zone (Northeast, Midwest, South, and West), and Country Forecast, 2024-2032

The U.S. dialysis services market size was valued at USD 26.63 billion in 2023. The market is projected to grow from USD 27.47 billion in 2024 to USD 43.67 billion by 2032, exhibiting a CAGR of 6.0% during the forecast period.

In recent years, the U.S. market has witnessed a steep demand for dialysis services, which are crucial for improving the quality of life for patients with chronic kidney disease (CKD). Due to the growing prevalence of chronic kidney diseases and end stage renal disease (ESRD), patient visits to dialysis clinics have increased over the last decade. The number of individuals receiving dialysis treatment is growing exponentially in the country.

• For instance, according to the United States Renal Data System (USRDS) 2023 annual report, in 2021, the number of newly registered ESRD patients in the U.S. was 135,972. In addition, the number of prevalent ESRD patients was 808,536 in 2021.


• Moreover, as per the data published by the National Institutes of Health (NIH) in May 2023, chronic kidney disease (CKD) affected more than 1 in 7 U.S. adults, an estimated 37.0 million Americans.

Furthermore, several service providers are undertaking various strategic initiatives, such as collaborations with hospitals, clinics, and dialysis centers to provide services for patients with ESRD. Due to the increasing patient population, key players in the market are involved in providing technology-related healthcare solutions and expanding their dialysis centers.

• For instance, in October 2023, DaVita Inc. announced a partnership with Google Cloud to develop a customized clinical operating system designed to transform kidney care. This new system helped the company streamline kidney care for more than 200,000 DaVita patients.

On the other hand, the growing number of dialysis centers in the country, coupled with favorable reimbursement policies, and increasing awareness regarding kidney health further increases the adoption of dialysis services.

The outbreak of COVID-19 adversely affected the U.S. market in 2020, particularly impacting patient groups with chronic diseases such as end-stage renal disease (ESRD). The pandemic significantly impacted the mortality rates of patients on hemodialysis and peritoneal dialysis.

The market is estimated to witness a slower growth in 2023. However, the rising number of dialysis patients and the return of the mortality rates to the pre-pandemic levels is expected to boost market growth in the coming years.

U.S. Dialysis Services Market Trends

Substantial Shift from In-Center Dialysis to Home Dialysis Identified is one of the Significant Market Trends

In recent years, there has been a notable surge in the popularity of home dialysis for the management of chronic kidney diseases. Dialysis services provide several benefits for patients receiving dialysis treatment at home as compared to the treatment provided at dialysis centers. Additionally, mortality rates in patients receiving dialysis at home are less than those treated at outpatient facilities. Due to these benefits, a larger patient population is shifting their dialysis treatments to homecare settings.

• For instance, as per the data published by Home Dialysis Central, in January 2023, the percentage of incident patients on home dialysis increased from 6.8% in 2010 to 13.3% in 2020. The rate of prevalent patients on home dialysis increased from 9.1% in 2010 to 13.7% in 2020.

In addition, governments in the country are introducing new payment schemes to improve the affordability and accessibility of kidney disease treatment, further encouraging the preference for low-cost home care. Owing to this, over the coming years, the number of patients receiving treatment in home care settings is expected to increase.

• For instance, in November 2020, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining the prospective payment system for end-stage renal disease, incorporating Medicare reimbursement for home dialysis. In this final rule, the CMS introduced a new transitional add-on payment for dialysis machines used in patients' homes.

Moreover, government authorities are also focusing on updating payment policies for home dialysis machines required during dialysis procedures.

• For instance, in October 2023, the CMS finalized additional steps for the Medicare Administrative Contractors to establish the basic payment of the TPNIES for home dialysis machines.

These factors support the shifting of a more significant proportion of individuals toward homecare dialysis in the U.S.

U.S. Dialysis Services Market Growth Factors

Rising Prevalence of Chronic Kidney Diseases to Increase the Services Demand

The rising cases of chronic kidney diseases CKD and renal failure are some of the important factors that have increased the adoption of these services in the country. The escalating number of individuals requiring dialysis is directly linked to the high prevalence of patients with chronic kidney disease. This factor is anticipated to boost demand for these services in the U.S. over the forecast period.

• For instance, as per the data published by the Centers for Disease Control and Prevention (CDC) in May 2023, approximately 14.0% of the adult population in the U.S. is diagnosed with CKD.


• Similarly, as per the data provided by NIH in May 2023, around 808,000 individuals in the U.S. were living with end-stage renal disease in 2020.

In addition, a rise in the number of patients opting for dialysis has resulted in an increasing demand for these services to manage their treatment. In response to this, service providers are adopting different strategies in order to meet the rising demand.

• For instance, in March 2022, Northwest Kidney Centers opened a new dialysis clinic in the Panther Lake area of Kent. The clinic, equipped with 11 dialysis stations, can accommodate almost 66 patients three times a week for blood-cleansing treatments.

Thus, the rising prevalence of renal failure and the increasing number of dialysis clinics in the country are expected to boost the patient population seeking dialysis treatment. This, in turn, will drive U.S. market growth.

Government Initiatives Offering Increased Access to Dialysis to Boost Market Growth

An important factor supplementing the market growth includes the initiatives undertaken by government authorities to increase access to dialysis services in the U.S. Healthcare providers face a huge burden in managing the growing patient pool for dialysis, prompting the U.S. government to implement various initiatives aimed at improving access to kidney care.

• For instance, in November 2023, the CMS published the Calendar Year (CY) 2024 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Final Rule. It includes ESRD QIP policies for payment years (PYs) 2026 to PY 2027.


• For instance, as per the data published by the National Institutes of Health (NIH) in February 2020, the federal government helped cover the treatment costs for people with kidney failure through its health insurance program, Medicare.

Furthermore, the launch of a health insurance program for patients with ESRD and funding for kidney-related research is projected to encourage self-care dialysis and enhance the quality of care for dialysis procedures. Due to the launches of federal healthcare programs for the management of kidney diseases, the number of patients receiving dialysis treatment is projected to increase, which in turn drives the demand for these services in the U.S.

RESTRAINING FACTORS

Growing Patient Pool Opting for Kidney Transplantation to Restrain Market Growth

As dialysis procedures are associated with certain complications and side effects, a kidney transplant is considered the choice of treatment by individuals with severe chronic kidney disease. The growing number of CKD patients opting for kidney transplants as a treatment option may hinder the market growth during the forecast period.

• For instance, according to the data published by the United Network for Organ Sharing in January 2023, 25,498 kidney transplants were performed in the U.S. in 2022.

Moreover, kidney transplant patients in the U.S. exhibited long-term survival rates compared to patients on dialysis. Due to this, the rate of kidney transplants being performed in the country has increased. 

• For instance, as per the data provided by the University of California San Francisco in September 2019, the patients who received kidney transplants have a survival rate of about 80%, while dialysis patients have a survival rate of less than 50% after five years.

Thus, these factors associated with kidney transplantation are expected to slow down the growth of the market up to a certain level.

U.S. Dialysis Services Market Segmentation Analysis

By Dialysis Type

Hemodialysis Segment Hold Largest Share Owing to Higher Number of Patients Undergoing This Dialysis Treatment

Based on dialysis type, the market is segmented into hemodialysis and peritoneal dialysis. 

Based on the dialysis type, the hemodialysis services segment dominated the market in 2023. This segment is further divided into acute hemodialysis and chronic hemodialysis sub-segments. The dominance of this segment is attributed to the larger acceptance of hemodialysis and the presence of a large number of dialysis centers that offer these services. In addition, factors such as the rising prevalence of diabetes and hypertension and the shortage of kidneys for transplantation in the U.S. are likely to augment market growth.

• For instance, as per the 2022 annual report of the U.S. Renal Data System (USRDS), the number of patients receiving hemodialysis approximately doubled to 480,516 between 2000 and 2020.

The peritoneal dialysis (PD) segment held a significant market share in 2023. Peritoneal dialysis works inside the body.  It is different from hemodialysis, which filters blood outside the body in a machine. PD treatments can be done at home or the workplace. The increase in the number of home dialysis adoptionscost-effectiveness, and higher patient convenience associated with PD are major reasons driving the segment's growth.  

• For instance, as per the data published by NIH in April 2022, the utilization rate of peritoneal dialysis in the U.S. increased from 22.0% in 2012 to 26.0% by 2019.

By End-user Analysis

Dialysis Centers Held the Largest Share Owing to High Patient Flow in These Facilities

By end-user, the market is segmented into dialysis centers, home healthcare, and hospitals.

The dialysis centers segment held the largest U.S. dialysis services market share in 2023. The larger population undergoing dialysis at outpatient centers is the prominent factor expanding the growth of dialysis centers in the U.S.  

• For instance, as per the DaVita Inc. annual report 2022, the company served 80% of its patients in outpatient hemodialysis centers.

Furthermore, healthcare providers are focusing on collaborations with dialysis centers and nephrology physicians to expand dialysis facilities across the country, fueling market growth. In addition, an increase in facility visits is also leading to the expansion of this segment.

• In July 2020, U.S. Renal Care, Inc. collaborated with Mercy Medical Center for dialysis care and services for the communities in Maryland.

On the other hand, the home healthcare segment is estimated to witness the fastest growth during the forecast period. The growth of the segment is attributed to collective initiatives made by the government and market players to shift dialysis from clinic setups to home care settings. In addition to this, increasing awareness regarding home dialysis, remote patient management (rpm), and telehealth services improves patient outcomes in home dialysis, ultimately supporting segment growth.

• For instance, according to the Fresenius Medical Care AG & Co. KGaA., Annual Report 2022, in the U.S., home dialysis is becoming increasingly important. About 15% of the company’s dialysis treatments were performed at home in the U.S.

The hospital segment is anticipated to grow at a considerable rate over the study period. This is due to increasing partnerships between hospitals and dialysis service providers in the country, which bolsters the segment’s growth.

• In August 2023, Fresenius Medical Care partnered with Sarah Bush Lincoln to deliver life-sustaining care for hemodialysis patients at their local hospital.

By Zone Analysis

South Segment Led Amongst the Zones Owing to a Large Number of Dialysis Centers in this Zone

Based on zone, the market is categorized into Northeast, Midwest, South, and West.

The Southern zone dominated the U.S. market with the highest market share in 2023. The factors contributing to the dominance of the region include the highest number of dialysis centers of key players coupled with the initiatives undertaken by the operating players to expand their presence in this region.

• For instance, in November 2023, Innovative Renal Care partnered with Vaughan Regional Medical Center to open a dialysis center at Selma of Dallas to provide service to people suffering from end-stage renal disease in Central Alabama.


• Similarly, in March 2022, U.S. Renal Care, Inc. expanded its in-center hemodialysis services in Southwest Florida by opening four additional facilities in the region.

On the other hand, the Midwest zone captured the second dominating position in the market.  High prevalence of end-stage kidney disease is one of the key factors that is driving the growth of the region.

• For instance, according to the data published by the American Kidney Fund in April 2021, out of 34,458 individuals living with end stage renal disease (ESRD) in Illinois, 23,578 patients were on dialysis. Similarly, the number was 1,302 in North Dakota.

Furthermore, the Northeast zone is growing slowly due to the limited number of dialysis centers, which leads to restricted access to the services in this zone. However, the opening of new dialysis centers in the region is expected to supplement the market growth in the coming years.

• For instance, in March 2022, the U.S. Congress provided funding of USD 1.0 million to NYC Health + Hospitals/Queens in order to construct a new outpatient dialysis center at the hospital.

List of Key Companies in U.S. Dialysis Services Market

DaVita Inc. Dominates the Market Owing to Well Established Network of Dialysis Centers Across the U.S.

The U.S. dialysis services sector has a high degree of consolidation, with top players, including DaVita Inc., and Fresenius Medical Care AG & Co. KGaA, operating in the market and accounting for a majority of the market share. The dominance of these companies is due to their continuous focus on the expansion of their service offerings, increasing strategic collaborations, and the strong emphasis on inorganic growth strategies for strengthening their market presence.

• In May 2022, DaVita Inc. and Medtronic collaborated to launch a new company, Mozarc Medical, to focus on kidney health. The newly launched company mainly focused on kidney health and patient-centered technology solutions. The launch of Mozarc Medical improves the lives of patients living with kidney disease by revolutionizing the approach to home dialysis.

Moreover, other players, such as U.S. Renal Care Inc., Satellite Healthcare, Innovative Renal Care, Northwest Kidney Centers, and Dialysis Clinic, Inc., are continuously involved in strategic expansion initiatives to establish their footprints in emerging regions.

• For instance, in April 2021, Innovative Renal Care acquired the Kidney Treatment Center of San Antonio (KTC), an independently owned and operated renal dialysis company offering personalized dialysis care to patients. The company acquired three dialysis centers operated by the Kidney Treatment Center of San Antonio (KTC) in San Antonio.

LIST OF KEY COMPANIES PROFILED:

• Fresenius Medical Care AG & Co. KGaA (U.S.)


• DaVita Inc. (U.S.)


• U.S. Renal Care Inc. (U.S.)


• Satellite Healthcare (U.S.)


• Innovative Renal Care (U.S.)


• Centers for Dialysis Care (U.S.)


• Northwest Kidney Centers (U.S.)


• Rogosin Institute (U.S.)


• Dialysis Clinic, Inc. (U.S.)

KEY INDUSTRY DEVELOPMENTS:

• November 2023: Innovative Renal Care collaborated with DeLorean Artificial Intelligence to transform kidney care by incorporating Artificial Intelligence (AI) in patient assessment to enhance patient outcomes.


• September 2023: DaVita Inc. collaborated with Adtalem Global Education to launch a curriculum to address the nephrology nurse shortage.


• September 2022: Satellite Healthcare collaborated with The Queen’s Health System, Kuakini Support Services Inc., to open Hawaii Kidney Care at Kuakini to offer dialysis services to patients who are at high risk and have end-stage renal disease.


• February 2022: Fresenius Medical Care AG & Co. KGaA collaborated with more than 1,000 nephrology providers in the U.S. Through this collaboration, the company helped to manage care for more than 50,000 people by providing specialized education and support services to slow the progression of kidney disease.


• August 2021: Fresenius Medical Care North America and Cigna have expanded their partnership to provide access to more than 2,600 dialysis centers and home dialysis options for members with ESRD.


• November 2020:Dialysis Clinic, Inc. collaborated with the Holston Medical Group to open a Kingsport Kidney Center (KKC) in Kingsport. The facility offers full-service kidney care and in-center hemodialysis, peritoneal, and home hemodialysis therapies to patients living with chronic kidney disease (CKD).

REPORT COVERAGE

The market research report provides a detailed analysis of the market. It focuses on key aspects such as competitive landscape, dialysis type, end-user, and zone. Besides this, it offers insights into the industry and market trends and highlights key industry developments. In addition to the factors mentioned above, the report encompasses several factors that have contributed to the growth of the market in recent years.

Report Scope & Segmentation

ATTRIBUTE	DETAILS
Study Period	2019-2032
Base Year	2023
Estimated Year	2024
Forecast Period	2024-2032
Historical Period	2019-2022
Growth Rate	CAGR of 6.0% from 2024-2032
Unit	Value (USD Billion)
Segmentation	By Dialysis Type Hemodialysis Acute Chronic Peritoneal dialysis
By End-user Dialysis Centers Home Healthcare Hospitals
By Zone Northeast Midwest South West