Fresenius Medical Care AG & Co. KGaA

Earnings Release • May 4, 2010

Fresenius Medical Care Reports strong start for 2010 and confirms outlook for full year

INVESTOR NEWS

First Quarter 2010 summary Table 1
Net revenue	\$ 2,882 million	+ 13%
Operating income (EBIT)	\$ 423 million	+ 7%
Net income attributable to Fresenius Medical Care AG & Co. KGaA	\$ 211 million	+ 7 %
Earnings per share	\$ 0.70	+ 6 %

Bad Homburg, Germany – Fresenius Medical Care AG & Co. KGaA ("the Company" or "FMC AG & Co. KGaA"), the world's largest provider of dialysis products and services, today announced its results for the first quarter of 2010.

Revenue

Net revenue for the first quarter of 2010 increased by 13 % to \$ 2,882 million (+ 10 % at constant currency) compared to the first quarter of 2009. Organic revenue growth worldwide was 8 %. Dialysis services revenue grew by 13 % to \$ 2,171 million (+ 11 % at constant currency) in the first quarter of 2010. Dialysis product revenue rose by 12 % to \$ 711 million (+ 5 % at constant currency) in the same period.

North America revenue increased by 10 % to \$ 1,960 million. Organic revenue growth was 8 %. Dialysis services revenue grew by 12 % to \$ 1,760 million. Average revenue per treatment for U.S. clinics increased to \$ 355 in the first quarter of 2010 compared to \$ 338 for the corresponding quarter in 2009. This development was attributable principally to reimbursement increases and increased utilization of pharmaceuticals. Dialysis product revenue increased by 1 % to \$ 200 million, led by higher sales of hemodialysis disposables and pharmaceuticals. In peritoneal dialysis we are focused on the continued market launch of the Liberty Cycler, resulting in a 13 % growth internally.

International revenue increased by 17 % to \$ 922 million. Based on constant currency, revenue grew by 8 %. Organic revenue growth was 6 %. Dialysis services revenue was \$ 411 million, an increase of 19 % (+ 9% at constant currency). Dialysis product revenue increased by 16 % to \$ 511 million (+ 7 % at constant currency), supported by higher sales of dialyzers and dialysis machines.

Earnings

Operating income (EBIT) for the first quarter of 2010 increased by 7 % to \$ 423 million compared to the first quarter of 2009. The operating margin decreased from 15.5 % in the first quarter of 2009 to 14.7 % in the first quarter of 2010.

In North America, the operating margin increased from 15.3 % in the first quarter of 2009 to 15.6 % in the first quarter of 2010. The margin development was impacted favorably by an increase in revenue per treatment and effective cost-containment measures.

In the International segment, the operating margin decreased from 18.7 % in the first quarter of 2009 to 16.4 % in the first quarter of 2010. The margin development was influenced negatively by the devaluation of the Venezuelan Bolivar.

Net interest expense for the first quarter of 2010 was \$ 67 million compared to \$ 74 million in the comparable quarter of 2009, mainly due to lower short-term interest rates.

Income tax expense was \$ 128 million for the first quarter of 2010 compared to \$ 111 million in the first quarter of 2009, reflecting effective tax rates of 35.8 % and 34.3 %, respectively.

Net income attributable to FMC AG & Co. KGaA for the first quarter of 2010 was \$ 211 million, an increase of 7 % compared to the first quarter of 2009.

Earnings per share (EPS) for the first quarter of 2010 rose by 6 % to \$ 0.70 per ordinary share. The weighted average number of shares outstanding for the first quarter of 2010 was approximately 299.6 million shares compared to 297.7 million shares for the first quarter of 2009. The increase in shares outstanding resulted from stock option exercises in the past 12 months.

Cash Flow In the first quarter of 2010, the Company generated \$ 349 million in cash from operations, an increase of 124 % compared to the first quarter of 2009 and representing approximately 12 % of revenue. The cash flow performance was influenced positively by improvements in working capital, increased earnings and lower income tax payments.

A total of \$ 99 million was spent for capital expenditures, net of disposals. Free cash flow before acquisitions was \$ 250 million compared to \$ 45 million in the first quarter of 2009. A total of \$ 82 million in cash was used for acquisitions net of divestitures. Free cash flow after acquisitions and divestitures was \$ 168 million compared to \$ 9 million in the first quarter of the previous year.

Please refer to the attachments for a complete overview on the first quarter of 2010 and the reconciliation of non-GAAP financial measures included in this release to the most comparable GAAP financial measures.

Patients – Clinics – Treatments As of March 31, 2010, Fresenius Medical Care treated 198,774 patients worldwide, which represents a 6 % increase compared to the previous year. North America provided dialysis treatments for 133,105 patients, an increase of 5 %. Including 30 clinics managed by Fresenius Medical Care North America, the number of patients in North America was 134,847. The International segment served 65,669 patients, an increase of 9 % over the prior year's figure.

As of March 31, 2010, the Company operated a total of 2,580 clinics worldwide, which represents a 5 % increase compared to the previous year. The number of clinics is comprised of 1,788 clinics in North America (1,818 including managed clinics), and 792 clinics in the International segment, representing an increase of 4 % and 8 %, respectively.

Fresenius Medical Care delivered approximately 7.51 million dialysis treatments worldwide during the first quarter of 2010. This represents an increase of 7 % over the same quarter last year. North America accounted for 5.03 million treatments, an increase of 6 %, and the International segment delivered 2.47 million treatments, an increase of 8 %.

Employees As of March 31, 2010, Fresenius Medical Care had 69,329 employees (full-time equivalents) worldwide compared to 67,988 employees at the end of 2009. This increase of 1,341 employees is due to overall growth in the Company's business.

Debt/EBITDA Ratio The ratio of debt to Earnings before Interest, Taxes, Depreciation and Amortization (EBITDA) decreased from 2.64 at the end of the first quarter of 2009 to 2.30 at the end of the first quarter of 2010.

Rating There have been no rating changes in the first quarter of 2010. On April 29, 2010, Standard & Poor's Rating Services has raised the outlook from 'stable' to 'positive'. Standard & Poor's continues to rate the Company's corporate credit as 'BB'. Moody's rates the Company's corporate credit as 'Ba1' with a 'stable' outlook. Fitch rates the Company's corporate credit as 'BB' with a 'stable' outlook. For further information on Fresenius Medical Care's credit ratings, maturity profiles and credit instruments, please visit our website at www.fmc-ag.com / Investor Relations/ Credit Relations.

Issuance of Senior Notes At the start of 2010, Fresenius Medical Care issued € 250 million aggregate principal amount of senior notes with a maturity in 2016. The proceeds from the issue were used to pay back short-term financial liabilities and for general business purposes.

Outlook for 2010 For the full year of 2010, the Company confirms its outlook.

Revenue is expected to grow to more than \$ 12 billion.

Net income attributable to FMC AG & Co. KGaA is expected to be between \$ 950 million and \$ 980 million in 2010.

The Company expects to spend \$ 550 million to \$ 650 million on capital expenditures and up to \$ 400 million on acquisitions. The debt/ EBITDA ratio is expected to be below 2.5 at the end of 2010.

"We are pleased to report a strong start for 2010 and we confirm our outlook for the full year," said Ben Lipps, chief executive officer of Fresenius Medical Care. "Strong organic growth is expected to continue and we also expect to strengthen our global presence through selective acquisitions, especially in the area of dialysis services. We had an excellent cash flow performance in the first quarter of 2010, supported by a continued impressive development in the days sales outstanding. Our most important goal for clinical and product research is to continue improving our patients' quality of life with innovative products and treatment concepts. We remain confident that we are well-positioned to meet our challenges, in particular the global reimbursement structural changes, and we look forward to the opportunity to further improve quality outcomes under these payment models."

Conference Call Fresenius Medical Care will hold a conference call to discuss the results of the first quarter of 2010 on Tuesday, May 4, 2010 at 3.30 p.m. CEDT / 9.30 a.m. EDT. The Company invites investors to view the live webcast of the call at the Company's website www.fmc-ag.com in the "Investor Relations" section. A replay will be available shortly after the call.

Fresenius Medical Care is the world's largest integrated provider of products and services for individuals undergoing dialysis because of chronic kidney failure, a condition that affects more than 1,890,000 individuals worldwide. Through its network of 2,580 dialysis clinics in North America, Europe, Latin America, Asia-Pacific and Africa, Fresenius Medical Care provides dialysis treatment to 198,774 patients around the globe. Fresenius Medical Care is also the world's leading provider of dialysis products such as hemodialysis machines, dialyzers and related disposable products. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME, FME3) and the New York Stock Exchange (FMS, FMS/ P).

For more information about Fresenius Medical Care, visit the Company's website at www.fmc-ag.com.

This release contains forward-looking statements that are subject to various risks and uncertainties. Actual results could differ materially from those described in these forward-looking statements due to certain factors, including changes in business, economic and competitive conditions, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, and the availability of financing. These and other risks and uncertainties are detailed in Fresenius Medical Care AG & Co. KGaA's reports filed with the U.S. Securities and Exchange Commission. Fresenius Medical Care AG & Co. KGaA does not undertake any responsibility to update the forward-looking statements in this release.

Statement of Earnings
Table 2 in US-\$ thousands, except
earnings per share and per
share data (unaudited)
		Three months ended March 31,
	2010	2009	Change
Net revenue
Dialysis care	2,170,784	1,923,321	12.9 %
Dialysis products	711,345	636,489	11.8 %
Total net reven ue	2,882,129	2,559,810	12.6%
Cost of revenue	1,917,837	1,697,505	13.0 %
Gross profit	964,292	862,305	11.8 %
Selling, general and administrative	517,714	443,567	16.7 %
Research and development	23,089	22,896	0.8 %
Oper ating inco me (EBIT)	423,489	395,842	7.0%
Interest income	(5,839)	(4,274)	36.6 %
Interest expense	73,264	78,564	– 6.7 %
Interest expense, net	67,425	74,290	– 9.2 %
Inco me before taxes	356,064	321,552	10.7%
Income tax expense1	127,528	110,380	15.5 %
Net income	228,536	211,172	8.2%
Less: Net income attributable to Noncontrolling interest1	17,420	13,066
Net inco me ATTRIBUTABLE TO FMC AG & CO. KGaA	211,116	198,106	6.6%
Oper ating inco me (EBIT)	423,489	395,842	7.0%
Depreciation and amortization	124,458	105,471	18.0 %
EBITDA	547,947	501,313	9.3%
Total bad debt expenses	60,271	53,010
Earnings per ordin ary share	\$0.70	\$0.67	5.9%
Earnings per ordin ary ADS	\$0.70	\$0.67	5.9%
Weighted average number of shares
Ordinary shares	295,746,635	293,932,036
Preference shares	3,889,994	3,811,297
In percent of revenue
Cost of revenue	66.5 %	66.3 %
Gross profit	33.5 %	33.7 %
Selling, general and administrative	18.0 %	17.3 %
Research and development	0.8 %	0.9 %
Oper ating inco me (EBIT)	14.7%	15.5%
Interest expense, net	2.3 %	2.9 %
inco me BEFORE taxes	12.4%	12.6%
Income tax expense	4.4 %	4.3 %
Net income attributable to Noncontrolling interest	0.6 %	0.5 %
Net inco me ATTRIBUTABLE TO FMC AG & CO. KGaA	7.3%	7.7%
EBITDA	19.0%	19.6%

¹ Due to the adoption of the new accounting rule ASC 810 (US GAAP), tax expenses related to minority interests of partnerships were reclassified to noncontrolling interest in 2009. The effect is neutral to net income attributable to FMC AG & Co. KGaA.

Segment and Other	Infor mation
in US-\$ million (unaudited)	Table 3
		Three months ended March 31,
	2010	2009	Change
Net revenue
North America	1,960	1,774	10.5 %
International	922	786	17.4 %
Total net reven ue	2,882	2,560	12.6%
Operating income (EBIT) North America	306	272	12.6 %
International	151	147	2.8 %
Corporate	(34)	(23)	47.1 %
tot al Oper ating inco me (EBIT)	423	396	7.0%
Operating income in percent of revenue
North America	15.6 %	15.3 %
International	16.4 %	18.7 %
tot al	14.7%	15.5%
Employees
Full-time equivalents	69,329	65,670

Reconciliation of non US-GAAP financial measures to the most directly comparable US-GAAP financial measures in US-\$ million

(unaudited) Table 4
	Three months ended March 31,
	2010	2009
Segment information North America
net reven ue	1,960	1,774
Costs of revenue and research and development	1,327	1,217
Selling, general and administrative	327	285
Costs of reven ue and oper ating expenses	1,654	1,502
Oper ating inco me (EBIT)	306	272
Percent of revenue	15.6 %	15.3 %
Dialysis products revenue incl. and excl. internal sales
North America
Dialysis products revenue incl. internal sales	365	345
Less internal sales	(166)	(148)
Dialysis products external sales	199	197
International
Dialysis products revenue incl. internal sales	603	514
Less internal sales	(91)	(74)
Dialysis products external sales	512	440
Reconciliation of cash flow from operating activities to EBITDA1
Total EBITDA	548	501
Interest expense, net	(67)	(74)
Income tax expense	(128)	(111)
Change in working capital and other non-cash items	(4)	(160)
Net cash provided by oper ating activities	349	156
Annualized EBITDA
Oper ating inco me (EBIT) last twe lve months	1,783	1,680
Depreciation and amortization last twelve months	476	425
Non-cash charges	51	45
Ann ualized EBITDA	2,310	2,150

¹ EBITDA is the basis for determining compliance with certain covenants in Fresenius Medical Care's long-term debt instruments.

Balance Sheet
Table 5 in US-\$ million
	March 31, (unaudited)	December 31, (audited)
	2010	2009
Assets
Current assets	4,789	4,728
Intangible assets	8,397	8,371
Other non-current assets	2,687	2,722
Total assets	15,873	15,821
Liabilities and equity
Current liabilities	4,022	2,610
Long-term liabilities	4,724	6,181
Total equity	7,127	7,030
Total liabilities AND equity	15,873	15,821
Equity/assets ratio :	45%	44%
Debt
Short-term borrowings	99	316
Short-term borrowings from related parties	10	10
Current portion of long-term debt and capital lease obligations	1,544	158
Long-term debt and capital lease obligations, less current portion	3,029	4,428
Trust Preferred Securities	628	656
Total debt	5,310	5,568

Cash Flow Statement
Table 6 Three months ended March 31,
in US-\$ million (unaudited)
	2010	2009
Operating activities
Net income	228	211
Depreciation / amortization	125	105
Change in working capital and other non cash items	(4)	(160)
Cash Flow fro m oper ating activities	349	156
Investing activities
Purchases of property, plant and equipment	(106)	(112)
Proceeds from sale of property, plant and equipment	7	1
Capital expenditures, net	(99)	(111)
Free Cash Flow	250	45
Acquisitions and investments, net of cash acquired and net purchases of intangible assets	(84)	(37)
Proceeds from divestitures	2	1
Acquisitions, net of divestitures Free Cash Flow after investing activities	(82) 168	(36) 9
Financing activities
Change in accounts receivable securitization program	(214)	–
Change in intercompany debt	–	15
Change in other debt	21	(34)
Proceeds from exercise of stock options	17	9
Distributions to noncontrolling interest	(34)	(14)
Contributions from noncontrolling interest	8	–
Dividends paid	–	–
Cash Flow fro m fin ancing activities	(202)	(24)
Effects of exchange rates on cash	(3)	(4)
Net DEcre ase in cash	(37)	(19)
Cash at beginning of period	301	222
Cash at end of period	264	203

	quarter ly Perfor mance Scorec ard	– Reven ue
Three months ended March 31,	Table 7
in US-\$ thousands, except per treatment revenue, unaudited
	2010	cc	2009	cc
North America
Net reven ue	1,959,689		1,773,813
Growth year-over-year	10.5 %		6.4 %
Dialysis Care	1,760,389		1,577,088
Growth year-over-year	11.6 %		5.5 %
U.S. per treatment	355		338
Per treatment	348		332
Sequential growth	– 0.6 %		0.5 %
Growth year-over-year	5.0 %		3.1 %
Dialysis Products
Incl. internal sales	365,416		344,603
Growth year-over-year	6.0 %		13.8 %
Extern al sales	199,299		196,724
Growth year-over-year	1.3 %		14.2 %
International
Net reven ue	922,223		785,843
Growth year-over-year	17.4 %	7.6 %	– 6.9 %	10.9 %
Dialysis Care	410,395		346,233
Growth year-over-year	18.5 %	8.9 %	– 0.8 %	18.0 %
Per treatment	166	152	151	179
Sequential growth	– 4.3 %		– 2.4 %
Growth year-over-year	10.0 %	1.1 %	– 10.3 %	6.7 %
Dialysis Products
Incl. internal sales	603,322		513,716
Growth year-over-year	17.4 %	7.4 %	– 10.7 %	6.6 %
Extern al sales	511,828		439,611
Growth year-over-year	16.4 %	6.7 %	– 11.2 %	5.9 %

cc = at constant exchange rates

Three months ended March 31, unaudited	Quarter ly Perfor mance Scorec ard – Dialysis Care Volume Table 8
		2010	2009
North America
Number of treatments		5,034,516	4,744,551
Treatments per day		65,383	62,428
Per day sequential growth		2.2 %	1.4 %
Per day year-over-year growth		4.7 %	3.4 %
Same market growth year-over-year		4.1 %	3.2 %
International
Number of treatments		2,474,048	2,296,623
Same market growth year-over-year		4.3 %	7.3 %

Quarter ly Perfor mance Scorec ard – Expenses
Table 9 Three months ended March 31, unaudited
	2010	2009
North America
Costs of revenue and operating expenses
In percent of revenue	84.4 %	84.7 %
Selling, general and administrative
In percent of revenue	16.7 %	16.1 %
Bad debt expenses
In percent of revenue	2.9 %	2.9 %
Dialysis Care operating expenses/ Treatment in US-\$	290	282
Sequential growth	2.7 %	2.0 %
Growth year-over-year	2.6 %	4.2 %
Total Group
Costs of revenue and operating expenses
In percent of revenue	85.3 %	84.5 %
Selling, general and administrative
In ercent of revenue	18.0 %	17.3 %
Effective tax rate	35.8 %	34.3 %

Quarter ly Perfor mance Scorec Cash Flow / Investing Activities Three months ended March 31, in US-\$ thousands, except Table 10 number of de novos, unaudited	ard –
	2010	2009
Total Group
Operating cash flow	349,088	155,564
In percent of revenue	12.1 %	6.1 %
Free cash flow before acquisitions	250,047	44,857
In percent of revenue	8.7 %	1.8 %
Acquisitions and investments, net of divestitures	81,578	35,614
Capital expenditures, net	99,041	110,707
In percent of revenue	3.4 %	4.3 %
Maintenance	56,985	56,009
In percent of revenue	2.0 %	2.2 %
Growth	42,056	54,698
In percent of revenue	1.5 %	2.1 %
Number of de novos	17	32
North America	7	25
International	10	7

Three months ended March 31, unaudited	Quarter ly perfor mance scorec ard – Balance Sheet Table 11
		2010	2009
Total Group
Debt in US-\$ million		5,310	5,672
Debt/ EBITDA		2.3	2.6
North America
Days sales outstanding		52	59
International
Days sales outstanding		111	109

Fresenius Medical Care 2010

Quarter ly Perfor mance Scorec ard
Table 12 Three months ended March 31,
	2010	2009
Clinical Performance
North America ( U.S.)
Single Pool Kt/v > 1.2	96 %	96 %
Hemoglobin = 10 – 12g /dl	65 %	62 %
Hemoglobin = 10 – 13g /dl	87 %	86 %
Albumin > = 3.5 g /dl1	83 %	80 %
Phosphate = 3.5 – 5.5mg /dl	55 %	53 %
Hospitalization days per patient2 (12 months ending March 31)	9.9	10.4
Demographics
North America ( U.S.)
Average age in years	62	62
Average time on dialysis in years	3.6	3.6
Average body weight in kg	81	80
Prevalence of diabetes	55 %	54 %

¹ International standard BCR CRM470

² Hospitalization data for 2009 includes legacy RCG facilities

Quarter ly Perfor mance Scorec ard
Table 13 Three months ended March 31,
	2010	2009
Clinical Performance
Europe, Middle East and Africa
Single Pool Kt/v > 1.2	95 %	94 %
Hemoglobin = 10 – 12g /dl	52 %	51 %
Hemoglobin = 10 – 13g /dl	77 %	75 %
Albumin > = 3.5 g /dl1	85 %	84 %
Phosphate = 3.5 – 5.5mg /dl	61 %	61 %
Hospitalization days per patient (12 months ending March 31)	8.9	8.2
Demographics
Europe, Middle East and Africa
Average age in years	64	64
Average time on dialysis in years	4.8	4.6
Average body weight in kg	71	69
Prevalence of diabetes	29 %	28 %

¹ International standard BCR CRM470

Contact

FreseniusMedical Care AG & CO. KGaA

investor relations Else-Kröner-Str. 1 61352 Bad Homburg, Germany Internet: www.fmc-ag.com

Oliver Maier

Phone: + 49 6172 609 26 01 Fax: + 49 6172 609 23 01 E-Mail: ir@fmc-ag.com

North America

Terry L. Morris Phone: + 1 800 948 25 38 Fax: + 1 615 345 56 05 E-Mail: ir@fmc-ag.com