##### 



Exhibit 2.34
  AMENDMENT
    NO. 2
  Dated as
    of January 31, 2008
  To that
    Certain
  BANK
    CREDIT AGREEMENT
  Dated as
    of March 31, 2006
  among
  FRESENIUS
    MEDICAL CARE AG & Co. KGaA,
  FRESENIUS
    MEDICAL CARE HOLDINGS, INC.
  and the
    other Borrowers and Guarantors identified therein,
  BANK OF
    AMERICA, N.A.,
    as Administrative Agent,
  DEUTSCHE
    BANK AG NEW YORK BRANCH,
    as Sole Syndication Agent,
  THE BANK
    OF NOVA SCOTIA,
    CREDIT SUISSE, CAYMAN ISLANDS BRANCH,
    and
    JPMORGAN CHASE BANK, NATIONAL ASSOCIATION,
 as
    Co-Documentation Agents,
  and
  THE
    LENDERS PARTY THERETO
   BANC OF
    AMERICA SECURITIES LLC
    and
 DEUTSCHE
    BANK SECURITIES INC.,
    as Joint Lead Arrangers and Book Running Managers




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AMENDMENT
    NO. 2
  Amendment FMCAG FMCH
  W I T N E
    S S E T H
  Bank Credit
    Agreement Term
    Loan Credit Agreement
        Amendment of the Bank Credit Agreement
  Definitions
    Amendment No. 2 Effectiveness Date means
    January 31, 2008
  Euro Equivalent
  FMCF-V
  Material Foreign Subsidiary
  Section 8.11(c)
  Pledge of Capital Stock.




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provided
  Senior Funded Debt
      (iii)
  (ii) (m) (n)
    Section 8.01
  Financial Covenants
  Conditions Precedent
          Section 2 Section 1
  Representations and Warranties; Defaults.




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Guarantor Acknowledgment
  Full Force and Effect
  Expenses
  Counterparts
  Governing Law
  [REMAINDER
    OF PAGE INTENTIONALLY LEFT BLANK]




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BORROWERS AND GUARANTORS:

FRESENIUS MEDICAL CARE AG & Co. KGaA,a German partnership limited byshares, represented by
FRESENIUS MEDICAL CARE MANAGEMENT AG, a German corporation, its general partner   By:
    /s/  Lawrence
    A. Rosen  Name:     Lawrence A. Rosen Title:
    Member of the Management Board  By:
    /s/  Dr. Rainer
    Runte  Name:     Dr. Rainer Runte Title:
    Member of the Management Board  PREAFIN III S.à r.l.
  By:
    /s/  Dr. Andrea
    Stopper  Name:     Dr. Andrea Stopper Title:
    Director




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BORROWER AND GUARANTOR:

FRESENIUS MEDICAL CARE HOLDINGS, INC., a New York
    corporation   By:
    /s/  Mark
    Fawcett  Name:     Mark Fawcett Title:
    Assistant Treasurer




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CO-BORROWERS
    AND GUARANTORS:
  NATIONAL MEDICAL CARE, INC.
 BIO-MEDICAL APPLICATIONS OF ALABAMA, INC.
 BIO-MEDICAL APPLICATIONS OF CALIFORNIA, INC.
 BIO-MEDICAL APPLICATIONS OF FLORIDA, INC.
 BIO-MEDICAL APPLICATIONS OF GEORGIA, INC.
 BIO-MEDICAL APPLICATIONS OF ILLINOIS, INC.
 BIO-MEDICAL APPLICATIONS OF INDIANA, INC.
 BIO-MEDICAL APPLICATIONS OF KENTUCKY, INC.
 BIO-MEDICAL APPLICATIONS OF LOUISIANA, LLC
 BIO-MEDICAL APPLICATIONS OF MICHIGAN, INC.
 BIO-MEDICAL APPLICATIONS OF MINNESOTA, INC.
 BIO-MEDICAL APPLICATIONS OF MISSISSIPPI, INC.
 BIO-MEDICAL APPLICATIONS OF NEW HAMPSHIRE, INC.
 BIO-MEDICAL APPLICATIONS OF NEW JERSEY, INC.
 BIO-MEDICAL APPLICATIONS OF NEW MEXICO, INC.
 BIO-MEDICAL APPLICATIONS OF NORTH CAROLINA, INC.
 BIO-MEDICAL APPLICATIONS OF OHIO, INC.
 BIO-MEDICAL APPLICATIONS OF PENNSYLVANIA, INC.
 BIO-MEDICAL APPLICATIONS OF SOUTH CAROLINA, INC.
 BIO-MEDICAL APPLICATIONS OF TENNESSEE, INC.
 BIO-MEDICAL APPLICATIONS OF TEXAS, INC.
 BIO-MEDICAL APPLICATIONS OF WEST VIRGINIA, INC.
 BIO-MEDICAL APPLICATIONS OF VIRGINIA, INC.
 FRESENIUS USA MANUFACTURING, INC.
 FRESENIUS USA MARKETING, INC.
 FRESENIUS USA, INC.
 SAN DIEGO DIALYSIS SERVICES, INC.
 SPECTRA LABORATORIES, INC.
 WSKC DIALYSIS SERVICES, INC.
 EVEREST HEALTHCARE INDIANA, INC.
  By:
    /s/  Mark
    Fawcett  Name:     Mark Fawcett Title:
    Treasurer




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GUARANTOR:

FRESENIUS MEDICAL CARE NORTH AMERICA HOLDINGS LIMITED
    PARTNERSHIP, a Delaware limited partnership   By:
    Fresenius Medical Care US Vermögensverwaltungs GmbH and Co.
    KG, a German limited partnership    By:
    Fresenius Medical Care Vermögensverwaltungs GmbH, a German
    limited liability company    By:
    /s/  Josef
    Dinger  Name:     Josef Dinger Title:
    Managing Director




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GUARANTORS:

FRESENIUS MEDICAL CARE DEUTSCHLAND GmbH, a German limited
    liability company   By:
    /s/  Dr. Emanuele
    Gatti  Name:     Dr. Emanuele Gatti Title:
    Managing Director  By:
    /s/  Rolf
    Groos  Name:     Rolf Groos Title:
    Managing Director  FRESENIUS MEDICAL CARE BETEILIGUNGSGESELLSCHAFT mbH,
  By:
    /s/  Dr. Emanuele
    Gatti  Name:     Dr. Emanuele Gatti Title:
    Managing Director  By:
    /s/  Dr. Rainer
    Runte  Name:     Dr. Rainer Runte Title:
    Managing Director  FRESENIUS MEDICAL CARE US BETEILIGUNGSGESELLSCHAFT mbH,
  By:
    /s/  Josef
    Dinger  Name:     Josef Dinger Title:
    Managing Director




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GUARANTORS:
    
    FRESENIUS MEDICAL CARE US ZWEI BETEILIGUNGSGESELLSCHAFT
    mbH, a German limited liability companyBy: /s/ Josef DingerName: Josef
    Dinger
    Title: Managing DirectorFRESENIUS MEDICAL CARE US DREI BETEILIGUNGSGESELLSCHAFT
    mbH, a German limited liability companyBy: /s/ Josef Dinger
    Name: Josef Dinger 
    Title: Managing DirectorFMC TRUST FINANCE S.à r.l. LUXEMBOURG, a private
    limited company (société à responsabilité
    limitée) organized under the laws of LuxembourgBy: /s/ Gabriele DuxName: Gabriele
    Dux
    Title: DirectorFMC FINANCE II S.à r.l., a private limited company
    (société à responsabilité limitée)
    organized under the laws of LuxembourgBy: /s/ Gabriele DuxName: Gabriele
    Dux
    Title: DirectorBy: /s/ Dr. Andrea StopperName: Dr. Andrea
    Stopper
    Title: Director




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GUARANTORS:
    
    FMC TRUST FINANCE S.à r.l. LUXEMBOURG-III, a private
    limited company (société à responsabilité
    limitée) organized under the laws of LuxembourgBy: /s/ Gabriele DuxName: Gabriele
    Dux
    Title: DirectorFMC FINANCE S.à r.l. LUXEMBOURG-IV, a private
    limited company (société à responsabilité
    limitée) organized under the laws of LuxembourgBy: /s/ Dr. Andrea StopperName: Dr. Andrea
    Stopper
    Title: DirectorNATIONAL MEDICAL CARE OF SPAIN, S.A., a corporation
    (sociedad anónima) organized under the laws of SpainBy: /s/ Dr. Emanuele GattiName: Dr. Emanuele
    Gatti
    Title: DirectorBy: /s/ Dr. Andrea StopperName: Dr. Andrea
    Stopper
    Title: DirectorFMC FINANCE III S.A., a Luxembourg corporationBy: /s/ Gabriele DuxName: Gabriele
    Dux
    Title: Director




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GUARANTORS:
    
    FRESENIUS MEDICAL CARE US ZWEI VERMÖGENSVERWALTUNGS
    GMBH & CO. KG, a German limited partnershipBy:  Fresenius Medical Care
    Vermögensverwaltungs GmbH, a
    German limited liability companyIts General PartnerBy: /s/ Josef DingerName: Josef
    Dinger
    Title: Managing Director




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GUARANTORS:
    
    BIO-MEDICAL APPLICATIONS MANAGEMENT COMPANY, INC., a
    Delaware corporationNMC A, LLC, a Delaware limited liability companyBIO-MEDICAL APPLICATIONS OF MAINE, INC., a Delaware
    corporationEVEREST HEALTHCARE HOLDINGS, INC, a Delaware
    corporationFRESENIUS MANAGEMENT SERVICES, INC, a Delaware
    corporationFMS NEW YORK, INC., a Delaware corporationRENAL CARE GROUP, INC., a Delaware corporationDIALYSIS CENTERS OF AMERICA  ILLINOIS, INC.,
    an Illinois corporationSTAT DIALYSIS CORPORATION, a Delaware corporationRENAL CARE GROUP OF THE MIDWEST, INC., a Kansas
    corporationBIO-MEDICAL APPLICATIONS OF MARYLAND, INC., a Delaware
    corporationFRESENIUS SECURITIES, INC., a California corporationSRC HOLDING COMPANY, INC., a Delaware corporationBy: /s/ Mark FawcettName: Mark
    Fawcett
    Title: Treasurer




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GUARANTOR:
    
    Bio-Medical Applications of Arizona, LLC (successor by
    merger to Bio-Medical Applications of Arizona, Inc.), a Delaware
    limited liability company
         By:  Bio-Medical
    Applications Management Company, Inc., its sole memberBy: /s/ Mark FawcettName: Mark
    Fawcett
    Title: Treasurer




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ADMINISTRATIVE AGENT:
    
    BANK OF AMERICA, N.A., for itself in its capacities as
    Administrative Agent and Collateral Agent and on behalf of the
    LendersBy: /s/ Angela LauName: Angela
    Lau
    Title: Assistant Vice President