Washington has sued the state's two largest for-profit dialysis providers, alleging that restrictions on kidney doctors' work have made it harder for competing clinics to open and offer patients more choices.
The case has a local connection: the state's complaint points to an Arlington clinic application disputed in 2018 and 2019 as an example of how noncompete agreements became part of the competition for dialysis services.
Attorney General Nick Brown announced the lawsuit Nov. 10. The office says it filed the case in Thurston County Superior Court against DaVita and Fresenius. The publicly linked complaint, dated Nov. 9, names DaVita Inc., Total Renal Care Inc., Fresenius Medical Care Holdings Inc. and Renal Care Group Northwest Inc.
The restrictions and their effects are allegations in a civil lawsuit. The state is asking the court to decide whether the agreements violate Washington law and to order relief.
How the restrictions could affect care
Dialysis filters waste and excess fluid from the blood when a person's kidneys can no longer do that work adequately. About 9,000 Washington residents receive dialysis, according to the Attorney General's Office. For many patients, treatment means repeated visits to a center for several hours at a time.
The lawsuit concerns kidney specialists hired as part-time medical directors at dialysis centers. The complaint describes these positions as independent-contractor roles overseeing a center's quality and safety.
The state alleges that the companies' agreements restrict medical directors from working for competing centers in the same area. Some provisions also purport to bind other doctors in the same nephrology practice or continue after a contract ends, according to the complaint.
Because centers need a medical director, the state argues, tying up available specialists can prevent competitors from opening. The complaint also alleges that the restrictions limit competition from providers offering home dialysis.
The Arlington connection
In paragraph 79 of the complaint, the state describes a dispute over a proposed Arlington center during the state's Certificate of Need application process in 2018 and 2019. It says DaVita and Fresenius raised noncompete restrictions when challenging competing applications.
The complaint recounts Puget Sound Kidney Centers' concern that restrictive agreements burdened the delivery of dialysis care amid a shortage of kidney specialists.
DaVita separately lists Smokey Point Home Dialysis at 16410 Smokey Point Blvd. in Arlington on its current center locator. That listing confirms the company's local presence; the lawsuit announcement does not identify a change to that site's services.
What the state is seeking
The complaint brings claims under Washington's Noncompetition Covenants Act and Consumer Protection Act. It asks for restrictions to be declared unenforceable, notices to affected physicians, an injunction and civil penalties.
The Nov. 10 release does not announce a clinic closure or treatment cancellation. Patients with questions about their own care or appointment schedule can contact their dialysis team.
Information checked Nov. 10, 2026. Sources: Washington Attorney General's Office, its publicly linked complaint and DaVita's center locator.
