Patients at for-profit dialysis center have lower kidneytransplantation rates

Results published in JAMA add to concerns that for-profit centers don't counsel patients about transplantation
Robert Calandra

A new study has found that patients with end-stage kidney disease treated at for-profit dialysis facilities in the United States, had a lower likelihood of being placed on the deceased donor kidney waiting list, receiving a deceased donor kidney, or receiving a living donor kidney transplant than patients treated at nonprofit facilities.

The study findings, reported in this week’s JAMA, come in the context of concerns (and some evidence)  that for-profit dialysis centers skimp on low-margin services such as counseling patients about transplantation and, furthermore, have an interest in impeding access to transplantation.

The researchers, led by Jennifer Gander, a Kaiser Permanente researcher, reported that patients receiving dialysis at for-profit facilities versus not-for-profit facilities had lower 5-year cumulative incidence rate for placement on the decreased kidney transplant waiting list (–13.2%), receipt of a living donor kidney transplant (–2.3%), and receipt of a decreased donor kidney transplant (–4.3%). It was a large study that included roughly 1.5 million patients treated at 6,500 dialysis centers.

Other studies have looked at the association between profit status and kidney transplantation. The authors of this study said theirs was the first to look at both living and deceased donor transplantation.