Consolidated statement of cash flows

January 1 to December 31, in million €	Note	2009	2008
Operating activities
Net income		991	683
Adjustments to reconcile net income to cash and cash equivalents provided by operating activities
Depreciation and amortization	16, 17, 18	562	783
Change in deferred taxes	11	11	113
Gain on sale of fixed assets		–	- 71
Changes in assets and liabilities, net of amounts from businesses acquired or disposed of
Trade accounts receivable, net	14	- 7	- 230
Inventories	15	- 92	- 107
Other current and non-current assets	16	- 96	- 102
Accounts receivable from / payable to related parties		- 4	- 10
Trade accounts payable, accrued expenses and other short-term and long-term liabilities		122	15
Accruals for income taxes		66	0
Net cash provided by operating activities		1,553	1,074
Investing activities
Purchase of property, plant and equipment		- 677	- 759
Proceeds from sales of property, plant and equipment		15	23
Acquisitions and investments, net of cash acquired and net purchases of intangible assets	2, 32	- 236	- 3,053
Proceeds from divestitures		9	96
Net cash used in investing activities		- 889	- 3,693

January 1 to December 31, in million €	Note	2009	2008
Financing activities
Proceeds from short-term borrowings	21	73	141
Repayments of short-term borrowings	21	- 296	- 186
Proceeds from long-term debt and capital lease obligations	21	700	2,417
Repayments of long-term debt and capital lease obligations	21	- 1,288	- 231
Proceeds from the issuance of Senior Notes	22	753	0
Repayments of liabilities from Senior Notes	22	- 100	0
Redemption of trust preferred securities of Fresenius Medical Care Capital Trusts	24	0	- 461
Proceeds from the issuance of bearer ordinary shares	27	0	143
Proceeds from the issuance of bearer preference shares	27	0	146
Payments of additional costs of capital increase	27	0	- 6
Proceeds from the issuance of mandatory exchangeable bonds	23	0	554
Changes of accounts receivable securitization program	21	- 233	309
Proceeds from the exercise of stock options	34	56	43
Dividends paid		- 275	- 245
Change in noncontrolling interest	26	- 2	- 2
Exchange rate effect due to corporate financing		1	2
Net cash used in / provided by financing activities		- 611	2,624
Effect of exchange rate changes on cash and cash equivalents		- 3	4
Net increase in cash and cash equivalents		50	9
Cash and cash equivalents at the beginning of the reporting period	13	370	361
Cash and cash equivalents at the end of the reporting period	13	420	370