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.

A preview of the emerging health care companies profiled in the current issue of Start-Up. This month's profile group, Protein Harvest, features profiles of Meristem Therapeutics; MPB Cologne GMBH; PhytaGenics Inc. and ProdiGene Inc. Plus these selected Start-Ups across Health Care: Gentris Corp.; HemoGenix LLC; Psychiatric Genomics Inc. and Zassi Medical Evolutions Inc.

ProdiGene Inc. was the first company to commercialize recombinant proteins from transgenic plants. It has used its head start to assemble a strong IP portfolio and form a number of strategic partnerships to advance its programs in proteins for biopharmaceutical and industrial applications. Using corn as its production vehicle, ProdiGene is close to hitting the market with an industrial enzyme, and will embark soon on clinical trials for edible human vaccines for e.coli and hepatitis B.