American Renal Associates runs dialysis centers across the United States

American Renal Associates is a for-profit dialysis provider that operates hundreds of outpatient dialysis centers in multiple states. If your doctor has referred you to one of their locations, or you are looking for a dialysis center in your area, this guide explains what the company does, how their centers work, and what to expect when you arrive for treatment.

American Renal Associates centers provide in-center hemodialysis — the most common form of dialysis in the United States. You will go to a physical location, usually three times per week, for sessions that last about four hours. A trained technician will connect you to a machine that filters waste and extra fluid from your blood.

The company also operates some peritoneal dialysis programs, though hemodialysis is their primary service. Your nephrologist (kidney specialist) will determine which type of dialysis is right for your medical situation and may refer you to a specific center based on location and your insurance.

Key Takeaways

  • American Renal Associates operates outpatient dialysis centers in multiple states, with hemodialysis as their main service.
  • Treatment typically happens three times per week for about four hours per session at a center location near your home.
  • Your nephrologist refers you to a specific center, and your insurance (Medicare, Medicaid, or commercial) determines what you pay.
  • You will need to complete intake paperwork, provide medical history, and meet with a social worker and dietitian as part of your first visit.
  • American Renal Associates centers employ nurses, technicians, and support staff who manage your treatment and monitor your health during each session.

How to find an American Renal Associates center near you

American Renal Associates maintains a center locator on their website where you can search by city or zip code. Enter your location and the tool will show you nearby facilities, their addresses, phone numbers, and sometimes their hours of operation. This is the fastest way to see which centers are in your area.

You can also call your nephrologist's office and ask which American Renal Associates center they recommend or have a relationship with. Many doctors work closely with specific centers and may have already arranged for you to be seen there. Your insurance company's website may also list in-network dialysis providers in your area.

If you do not yet have a nephrologist, your primary care doctor can refer you to one, or you can contact your local hospital's nephrology department. Once you have a nephrologist, they will handle the referral to a specific dialysis center.

What happens at your first appointment

When you arrive for your first visit, you will check in at the front desk and complete intake paperwork. This includes your medical history, current medications, emergency contact information, and insurance details. Bring your insurance card and photo ID.

A nurse will take your vital signs (blood pressure, temperature, weight) and review your medical records. You will meet with a social worker who can discuss transportation, financial concerns, work schedules, and other practical matters related to your treatment. The social worker can also connect you with resources if you need help paying for dialysis or related expenses.

A renal dietitian will talk with you about diet and fluid restrictions. Dialysis patients follow specific guidelines about sodium, potassium, phosphorus, and fluid intake, and the dietitian will explain why these matter and how to manage them. You will also receive written materials about your treatment plan.

Your first actual dialysis session may happen on this day or be scheduled for a later date, depending on the center's schedule and your medical readiness. The nurse will explain the process step by step before connecting you to the machine.

Insurance and payment at American Renal Associates centers

Most dialysis patients are covered by Medicare, which pays for dialysis treatment for people with end-stage renal disease (ESRD) regardless of age. If you have ESRD and are not yet on Medicare, you become may be able to access for it. Your center's billing department will help you understand your coverage.

Medicaid covers dialysis in every state, though the amount it pays varies by state. If you have both Medicare and Medicaid (called "dual may be able to access"), both programs work together to cover your care. Commercial insurance (through an employer or purchased individually) also covers dialysis, often with a copay per session.

You may have out-of-pocket costs depending on your insurance plan. These can include copays, coinsurance, or deductibles. The center's financial counselor can explain your specific costs and may know about programs that help dialysis patients pay for treatment, medications, or transportation.

If you do not have insurance, tell the center when ready. Many dialysis centers have financial information programs or can connect you with nonprofits that help uninsured patients. Do not delay starting dialysis because of cost concerns — the center has resources to discuss.

What to bring and what to expect during treatment

Bring your insurance card and photo ID to every session. Wear comfortable, loose-fitting clothing with sleeves that roll up easily — the technician needs access to your arm for needle placement. Avoid wearing jewelry or watches on the arm that will be used for dialysis.

During treatment, you will sit in a comfortable chair or recline on a bed. The technician will clean the area where needles will be inserted (usually your arm or leg) and place two needles: one to remove blood and one to return it. You may feel a small pinch, but the area is numbed first.

Once you are connected to the machine, you can read, watch television, sleep, or work on a laptop — many centers have Wi-Fi. The machine does the work of filtering your blood. A nurse monitors you throughout the session and checks your blood pressure and how you are feeling.

Sessions last about four hours. Near the end, the technician will slowly return all your blood to your body and remove the needles. You may feel tired after treatment, and many patients rest for a few hours afterward. This is normal.

Creating a vascular access for dialysis

Before you can start hemodialysis, you need a vascular access — a way for the dialysis machine to safely remove and return large amounts of blood. There are three main types: an arteriovenous fistula (AV fistula), an arteriovenous graft (AV graft), or a temporary catheter.

An AV fistula is created by a surgeon who connects an artery directly to a vein, usually in your arm. This creates a larger vein that can handle the blood flow needed for dialysis. It takes several weeks to mature and become ready for use, but it lasts the longest and has the fewest complications. This is the preferred access type.

An AV graft is a synthetic tube that connects an artery to a vein. It can be used sooner than a fistula (usually within two weeks) but does not last as long and requires more monitoring. A temporary catheter is a tube placed in a large vein in your chest, neck, or leg. It can be used right away but is meant for short-term use only because of infection risk.

Your nephrologist will refer you to a vascular surgeon to discuss which access is best for you. This surgery happens before you start dialysis, so plan ahead. Your American Renal Associates center can coordinate with the surgeon and help you understand the timeline.

Frequently Asked Questions

Can I choose which American Renal Associates center I go to?

Your nephrologist typically refers you to a specific center based on location, your schedule, and their relationship with that facility. If you have a strong preference for a different center, discuss it with your doctor — they may be able to refer you elsewhere if it makes sense for your care.

What if I miss a dialysis session?

Missing sessions is dangerous because waste and fluid build up in your blood. If you cannot make a scheduled session, call the center as soon as possible. The medical team may be able to reschedule you or discuss what happened. Chronic missed sessions can affect your health and your treatment plan.

Do I need to follow a special diet while on dialysis?

Yes. Dialysis patients follow restrictions on potassium, phosphorus, sodium, and fluid intake because dialysis only partially replaces kidney function. The renal dietitian at your center will create a meal plan for you and explain why each restriction matters. Following the diet helps dialysis work better and keeps you healthier.

Can I work while going to dialysis three times a week?

Many dialysis patients work, though it depends on your job and how you feel during and after treatment. Some centers offer evening or weekend sessions to fit work schedules. Talk with the social worker at your center about your work situation — they can help you find a schedule that works and may know about workplace protections for dialysis patients.

What happens if I want to switch to home dialysis or a different provider?

You can transfer to another dialysis center or explore home dialysis options (nocturnal hemodialysis or peritoneal dialysis) by discussing it with your nephrologist. Your medical records and vascular access information will transfer with you. The center's social worker can help coordinate the move.