Dialysis prolongs the lives of patients with end-stage renal disease, but outcomes are still poor, with a 17% mortality rate in the US. Nephrologists and technology developers want to improve outcomes, but the economics of dialysis have stymied innovation. Medicare tightly controls pricing, and developers are hard-pressed to find therapies that increase clinical benefits but not cost. Recently, two major clinical trials in dialysis hint that the benefits of dialysis, as it's currently performed, are approaching their limits. Start-ups now have the ammunition with which to approach a technologically stagnant market. Small companies, however, face daunting competition: three giant players dominate the market, two of which own 40% of the service centers that provide dialysis therapies.

Several forces--rapid technological obsolescence, the impact of information technology on health care, merger integrations, and the need for double digit revenue growth--have caused increasing numbers of large pharmaceutical and medical device companies to create new corporate venture capital groups. But compared to traditional VC firms, whose only goal is to make money for limited partners, corporate VCs have a heavy agenda. They must choose portfolio companies while balancing often-competing goals of strategic benefit and financial return.