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Consolidated statement of cash flows

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January 1 to December 31, € in millions Note 2021 2020
Operating activities      
Net income   2,819 2,823
Adjustments to reconcile net income to cash and cash equivalents provided by operating activities      
Depreciation and amortization 18, 19, 20, 31 2,667 2,715
Change in deferred taxes 11 84 43
Loss / Gain on sale of fixed assets and of investments and divestitures 2 42 -60
Changes in assets and liabilities, net of amounts from businesses acquired or disposed of      
Trade accounts and other receivables 16 87 -26
Inventories 17 -105 -527
Other current and non-current assets 18 -320 -252
Accounts receivable from / payable to related parties   -10 13
Trade accounts payable, provisions and other short-term and long-term liabilities 21, 22 -154 1,819
Liabilities for income taxes   -32 1
Net cash provided by operating activities   5,078 6,549
Investing activities      
Purchases of property, plant and equipment and capitalized development costs 19 -2,047 -2,406
Proceeds from sales of property, plant and equipment   30 40
Acquisitions and investments and purchases of intangible assets 2, 34 -999 -720
Proceeds from sale of investments and divestitures 2 199 75
Net cash used in investing activities   -2,817 -3,011

Consolidated statement of cash flows

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January 1 to December 31, € in millions Note 2021 2020
Financing activities      
Proceeds from short-term debt 23 3,279 282
Repayments of short-term debt 23 -688 -2,529
Proceeds from long-term debt 23 458 61
Repayments of long-term debt 23 -3,028 -1,438
Repayments of lease liabilities 31 -880 -937
Proceeds from the issuance of bonds 24 2,714 4,577
Repayments of liabilities from bonds 24 -2,253 -937
Repayments of convertible bonds 25 -400
Payments for the share buy-back program of Fresenius Medical Care 28 -366
Payments for the Accounts Receivable Facility of Fresenius Medical Care 23 -374
Proceeds from the exercise of stock options 36 38 18
Dividends paid   -1,068 -1,060
Change in noncontrolling interests, net 27 -24 -14
Net cash used in financing activities   -1,452 -3,117
Effect of exchange rate changes on cash and cash equivalents   118 -238
Net increase in cash and cash equivalents   927 183
Cash and cash equivalents at the beginning of the reporting period 15 1,837 1,654
Cash and cash equivalents at the end of the reporting period 15 2,764 1,837

Additional information on payments that are included in net cash provided by operating activities

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January 1 to December 31, € in millions Note 2021 2020
Received interest   94 66
Paid interest   -517 -627
Income taxes paid   -750 -765
The following notes are an integral part of the consolidated financial statements.