An investigation by a CBS News Data Team found that death rates for kidney dialysis patients in the United States are among the highest in the industrialized world: one-third of the nation’s dialysis centers have failed to meet federal performance standards.
Texas, which has the highest number of dialysis centers in the United States, ranks 13th nationwide for dialysis centers with federal penalties: North Texas has the second highest penalty rates in Texas (Houston has the highest).
The investigation found that dialysis centers in the United States have been cited for more than 115,000 deficiencies since 2013, ranging from unsanitary conditions to inadequate staff training. Two-thirds of the deficiencies were found at dialysis facilities owned or operated by Fresenius or DaVita, which together operate nearly 80% of the dialysis centers in the United States. In North Texas, DaVita operates 49 dialysis centers and Fresenius operates 55 (together comprising approximately 61% of the dialysis centers in North Texas).
The investigation found that 72 of 170 dialysis centers in the Dallas–Fort Worth area were penalized for poor performance across key quality and safety measures, such as patient safety and hospitalizations. 35.8% of dialysis centers (264) in Texas were penalized by the federal government in 2025, for poor performance across key quality and safety measures, such as patient safety and hospitalizations.
DaVita issued the following statement regarding the findings of the investigation: “For more than 25 years, DaVita has committed to providing high-quality kidney care and improving lives—one patient, one community at a time. From neighborhoods across Texas to centers in 15 countries, our experience drives innovation and allows us to support communities in need. This commitment to Texas communities is reflected in our Community Health Experience, an initiative that brings free health screenings and education to under-resourced neighborhoods. We believe in accessible, life-sustaining care for all and a comprehensive approach to clinical performance.”
Fresenius issued the following statement regarding the findings of the investigation: “We deny the allegations in the complaint and are vigorously defending both our staff and the care that was provided. Our teams remain focused on delivering safe, high-quality care and improving outcomes for the patients we serve. By any objective measure, our ability to hire qualified staff, deliver best-in-class patient care, and innovate for the betterment of people living with kidney disease far outpaces the industry.”
A study published in 1991 that sought to identify the causes of death in maintenance dialysis patients who survived at least 90 days and were monitored during a 16-year period, found that of 532 patients starting dialysis, 222 died. The causes of death were grouped into six categories: cardiac, infectious, withdrawal from dialysis, sudden, vascular, and “other.” The greatest number of deaths were due to infections, followed by withdrawal from dialysis, cardiac, sudden death, vascular, and other. The risk of dying increased for the first 4 years of dialysis, decreased in years 5 through 10, and had a second increase at 11 years. The mortality during the first 4 years consisted largely of infectious and cardiac deaths. The late peak of deaths was mainly due to infections and withdrawal from dialysis. Overall, infections accounted for more than 36% of all deaths. Withdrawal occurred in 21.2% of the patients and was most common in patients over age 61. Cardiac deaths accounted for only 14.4% of all deaths and no patient died from a cardiac cause after surviving on dialysis more than 8.5 years.
The researchers concluded that infection is the leading cause of death in the dialysis patient population. Withdrawal from dialysis was a common cause of death, especially in older patients. Cardiac mortality was not as frequent as anticipated and occurred mainly in patients on dialysis less than 4 years, suggesting that it is the result of preexisting disease.
A study published in May 2025 found that about 25% of sudden cardiac arrest (SCA) cases among dialysis patients were associated with the dialysis procedure, a rate nearly three times higher than expected by chance. SCA events were more likely to occur on dialysis days, especially after long interdialytic periods, such as on Mondays and Tuesdays. A significant portion (23.4%) of SCA events associated with dialysis occurred within the first hour postdialysis, highlighting the need for careful monitoring.
If you or a loved one were injured (or worse) as a result of dialysis in the United States, you should promptly find a medical malpractice lawyer in your state who may investigate your dialysis medical malpractice claim for you and represent you or your loved one in a dialysis malpractice case, if appropriate.
Visit our website or call us on our toll-free number in the United States (800-295-3959) to find dialysis malpractice attorneys in your state who may help you.
Turn to us when you don’t know where to turn.
