Patients with kidney disease who are treated in for-profit dialysis centers are 20% more likely to die than those treated in nonprofit centers, according to a study to be published today in the New England Journal of Medicine.

The report, which was met with skepticism by key dialysis organizations, including the National Kidney Foundation, is sure to further inflame debate over whether health care has become too profit- driven.

As in other areas of health care, there has been huge growth among for-profit dialysis clinics since the early 1990s. But the same factors that have spelled economic disaster for many hospitals, health plans and physician groups--too-rapid growth and overly optimistic earnings projections--have caused these highflying companies to crash as well.