Document:

EX-10.1

 Exhibit 10.1 

AMEDISYS HOLDING, L.L.C. 

SEVERANCE PLAN FOR KEY EXECUTIVES 

APRIL 30, 2015 
 Inclusive of all
Amendments to Section 2 dated on or before December 17, 2015 
 1. Purpose. The purpose of this Amedisys Holding, L.L.C.
Severance Plan for Key Employees (this “Plan”) is to provide a fair framework in the event of the termination of employment in certain circumstances of certain key executive employees of the Company. This document supersedes any prior
plan, program or arrangement that provides severance benefits to a Covered Executive (as defined below) eligible for benefits under this Plan. This document is intended to serve both as the official plan document and the summary plan description for
this Plan. The Plan is sponsored by Amedisys Holding, L.L.C. (“Company”). The Company is the Plan Administrator. 
 2. Covered
Executives. To be eligible for benefits under this Plan an executive must (1) be employed by the Company with any of the following job titles: Chief Operating Officer, Chief Financial Officer, Vice Chairman, Chief Human Resources Officer,
Senior Vice President of Government Affairs, General Counsel, Chief Information Officer, Chief Strategy Officer, Chief Clinical Operations Officer, Chief Development Officer, Senior Vice President of Accounting/Controller, Senior Vice President of
Operations, Senior Vice President of Talent, or Senior Vice President of Total Rewards; (2) have been designated in writing by the Board of Directors (the “Board”) of Amedisys, Inc. or the Compensation Committee of the Board (the
“Committee”), as appropriate, as being covered by this Plan; and (3) have executed and delivered to the Company (and not have revoked or attempted to revoke) the Company’s Executive Protective Covenants Agreement
(“EPCA” or other similarly named agreement) (a “Covered Executive”). 
 This Plan shall not be applicable to any
employee who is a party to a separate employment agreement, change of control agreement, or similar agreement with the Company. 
 If a
Covered Executive under this Plan is or becomes eligible to participate in the April 2013 Severance Plan for Senior Management Leaders, then such employee will only be eligible for severance benefits under the terms of the April 2013 Severance Plan
for Senior Management Leaders, except in the event of a “Change in Control” (as such term is defined in Section 3, below), in which case the terms of this Plan (including, without limitation, the provisions of Section 5, herein)
shall control, regardless of whether such employee still qualifies as a Covered Executive. In no event will a Covered Executive be entitled to simultaneously receive benefits under both the April 2013 Severance Plan for Senior Management Leaders and
this Plan. 
 3. Definitions. 

(a) Cause. “Cause,” as it applies to the determination by the Company to terminate the employment of a Covered Executive,
shall mean any one or more of the following: (i) Covered Executive’s willful, material, and irreparable breach of Covered Executive’s duties 

  
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to the Company; (ii) Covered Executive’s gross negligence in the performance or intentional nonperformance of any of Covered Executive’s material duties and responsibilities to the
Company; (iii) Covered Executive’s willful dishonesty, fraud, or misconduct with respect to the business or affairs of the Company, which materially and adversely affects the operations or reputation of the Company; (iv) Covered
Executive’s conviction or plea of nolo contendere to a felony crime; and (v) Covered Executive engages in an act or series of acts constituting misconduct resulting in a misstatement of a Company’s financial statements due to material
non-compliance with any financial reporting requirement within the meaning of Section 304 of The Sarbanes Oxley Act of 2002. In the event of a termination by the Company for Cause, Covered Executive shall have no right to any severance benefits
under this Plan. 
 (b) Code. “Code” shall mean the United States Internal Revenue Code of 1986, as amended, or any
successor provision of law, and the regulations promulgated thereunder. 
 (c) Good Reason. “Good Reason,” as it applies to
the determination by a Covered Executive to terminate Covered Executive’s employment with the Company at his or her initiative shall mean the occurrence of any of the following events without Covered Executive’s written consent:
(i) Covered Executive suffers a material diminution in authority, responsibilities, or duties; or (ii) Covered Executive suffers a material reduction in base salary other than in connection with a proportionate reduction in the base
salaries of all similarly situated senior officer-level employees. Good Reason shall not be deemed to have occurred unless (i) Covered Executive provides the Company with notice of one of the conditions described above within 90 days of the
existence of the condition, (ii) the Company is provided at least 30 days to cure the condition and fails to cure same within such 30 day period and (iii) Covered Executive terminates employment within at least 150 days of the existence of
the condition. 
 (d) Employment Termination. “Employment Termination” shall mean a Covered Executive no longer being an
employee of the Company as a result of a termination by the Company without Cause or by Covered Executive with Good Reason. 
 (e) Change
in Control. A “Change in Control” shall be deemed to have occurred if: 
 a. any person or entity, including a
“group” as defined in Section 13(d)(3) of the Exchange Act, other than the Company or a wholly-owned Subsidiary, or any employee benefit plan of the Company or any Subsidiary, becomes the beneficial owner of the Company’s
securities having 50% or more of the combined voting power of the then outstanding securities of the Company that may be cast for the election of directors of the Company (other than as a result of an issuance of securities initiated by the Company
in the ordinary course of business); or 
 b. as the result of, or in connection with, any cash tender or exchange offer,
merger or other business combination, sales of assets or contested election, or any combination of the foregoing transactions, after the transaction less than a majority of the 

  
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combined voting power of the then outstanding securities of the Company, or any successor corporation or cooperative or entity, entitled to vote generally in the election of the directors of the
Company, or other successor corporation or other entity, are held in the aggregate by the holders of the Company’s securities who immediately prior to the transaction had been entitled to vote generally in the election of directors of the
Company; or 
 c. during any period of 2 consecutive years, individuals who at the beginning of the period constitute the
Board cease for any reason to constitute at least a majority of the Board, unless the election, or the nomination for election by the Company’s stockholders, of each director of the Company first elected during the relevant 2-year period was
approved by a vote of at least 2/3 of the directors of the Company then still in office who were directors of the Company at the beginning of that period. 

4. Result of Termination by the Company without Cause or by Covered Executive with Good Reason Prior to a Change in Control. The
following provisions shall apply should the Company terminate a Covered Executive’s employment without Cause or should a Covered Executive terminate Covered Executive’s employment with Good Reason: 

(a) Salary and Bonus. The Company shall pay to Covered Executive an amount equal to one (1) times the sum of (A) the Covered
Executive’s base salary, as in effect on the date of Employment Termination (or in the event a reduction in base salary is a basis for a termination with Good Reason, then the base salary in effect immediately prior to such reduction) and
(B) the greater of (x) an amount equal to the cash bonus earned by the Covered Executive for the previous fiscal year or (y) an amount equal to twenty-five (25) percent of the Covered Executive’s base salary, as in effect on
the date of Employment Termination (or, in the event a reduction in base salary is a basis for termination for Good Reason, then the base salary in effect immediately prior to such reduction), which amount shall be payable in substantially equal
monthly installments in accordance with the Company’s normal payroll practices for a period of 12 months and which payments shall commence in accordance with the provisions of Section 6, herein (unless otherwise required to be paid in
accordance with Section 7 below). 
 (b) Lump-sum Payment. The Company shall pay to Covered Executive a lump-sum payment of
$2,500 for the intended purpose of purchasing health insurance, but which can be used at the discretion of the Covered Executive. 
 (c)
Stock Vesting. Any unvested equity awards issued in the name of Covered Employee as of the date of termination, will vest in accordance with the terms contained in the applicable Award Agreement for such awards. 

5. Termination by the Company without Cause or Termination by Covered Executive with Good Reason Following a Change in Control. The
following provisions shall apply should the Company terminate a Covered Executive’s employment without Cause or should a Covered Executive terminate Covered Executive’s employment with Good Reason, in either case within one year following
a Change in Control (as defined above): 
 (a) Salary and Bonus. The Company shall pay to Covered Executive (i) an amount equal
to two (2) times the sum of (A) the Covered Executive’s base salary, as in effect on the date of Employment Termination (or in the event a reduction in base salary is a basis for a termination with Good Reason, then the base salary in
effect immediately prior to such reduction) and (B) the greater of (x) an amount equal to the cash bonus earned by the Covered Executive for the previous fiscal year or (y) an amount equal to twenty-five (25) percent of the
Covered Executive’s base salary, as in effect on the date of Employment Termination (or, in the event a reduction in base salary is a basis for termination for Good Reason, then the base salary in effect immediately prior to such reduction),
which amount shall be payable in a lump sum on the date or dates specified in Section 6, herein (unless otherwise required to be paid in accordance with Section 7 below). 

  
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 (b) Lump-sum Payment. The Company shall pay to Covered Executive a lump-sum payment of
$2,500 for the intended purpose of purchasing health insurance, but which can be used at the discretion of the Covered Executive. 
 (c)
Stock Vesting. Any unvested equity awards issued in the name of Covered Employee as of the occurrence of a Change in Control will vest in accordance with the provisions of the Amedisys, Inc. 2008 Omnibus Incentive Compensation Plan, as the
same may be amended from time to time, or any successor plan thereto. 
 6. Release of Claims. The Company’s obligations under
this Plan are contingent upon Covered Executive’s executing (and not revoking during any applicable revocation period) a valid, enforceable, full and unconditional release of all claims Covered Executive may have against the Company, Amedisys,
Inc. and their respective directors, officers, employees, subsidiaries, stockholders, successors, assigns, agents, representatives subsidiaries and affiliates (whether known or unknown) as of the date of Employment Termination in such form as
provided by the Company no later than 60 days after the date of Employment Termination. If the foregoing release is executed and delivered and no longer subject to revocation within 60 days after the date of Employment Termination, then the
following shall apply: 
 (a) To the extent any payments due to Covered Executive under this Plan are not “deferred compensation”
for purposes of Section 409A of the Code then such payments shall commence upon the first regularly-scheduled payment date immediately following the date the release is executed and no longer subject to revocation (the “Release Effective
Date”). The first such cash payment shall include payment of all amounts that otherwise would have been due prior to the Release Effective Date under the terms of this Plan had such payments commenced after the date of Employment Termination,
and any payments to be made thereafter shall continue as provided herein. The delayed payments shall in any event expire at the time such payments would have expired had such payments commenced after the date of Employment Termination. 

(b) To the extent any payments due to Covered Executive under this Plan above are “deferred compensation” for purposes of
Section 409A, then such payments shall commence upon the 60th day following the date of Employment Termination. The first such cash payment shall include payment of all amounts that otherwise would have been due prior

  
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thereto under the terms of this Plan had such payments commenced after the date of Employment Termination, and any payments to be made thereafter shall continue as provided herein. The delayed
payments shall in any event expire at the time such payments would have expired had such payments commenced immediately following the date of Employment Termination. 

7. Section 409A. Notwithstanding any provisions in this Plan to the contrary, if at the time of the Employment Termination the
Covered Executive is a “specified employee” as defined in Section 409A and the deferral of the commencement of any payments or benefits otherwise payable as a result of such Employment Termination is necessary to avoid the additional
tax under Section 409A, the Company will defer the payment or commencement of the payment of any such payments or benefits (without any reduction in such payments or benefits ultimately paid or provided to Covered Executive) until one day after
the day which is six months from the date of Employment Termination. Any monthly payment amounts deferred will be accumulated and paid to Covered Executive (without interest) six months after the date of Employment Termination in a lump sum, and the
balance of payments due to Covered Executive will be paid as otherwise provided in this Plan. Each monthly payment described in this Plan is designated as a “separate payment” for purposes of Section 409A and, subject to the six month
delay, if applicable, and the first monthly payment shall commence on the payroll date as in effect on termination following the termination. For purposes of this Plan, a termination of employment means a separation from service as defined in
Section 409A. No reimbursement payable to Covered Executive pursuant to any provisions of this Plan or pursuant to any plan or arrangement of the Company shall be paid later than the last day of the calendar year following the calendar year in
which the related expense was incurred, and no such reimbursement during any calendar year shall affect the amounts eligible for reimbursement in any other calendar year, except, in each case, to the extent that the right to reimbursement does not
provide for a “deferral of compensation” within the meaning of Section 409A. This Plan will be interpreted, administered and operated in accordance with Section 409A, although nothing herein will be construed as an entitlement to
or guarantee of any particular tax treatment to Covered Executive. 
 8. Claims Procedure. If a Covered Executive does not receive a
benefit to which the Covered Executive believes he or she is entitled under the Plan, or if the Covered Executive believes that the Covered Executive is entitled to a greater benefit than was approved, the Covered Executive must, within 60 days
following the date of Employment Termination, file a written claim with the Plan Administrator. The Plan Administrator will investigate the claim and will send the Covered Executive a written decision within 60 days from the date upon which it
receives the claim. If the claim is denied, the written decision will specify the reasons for the denial (including the pertinent Plan provisions upon which the denial is based), as well as an explanation of how the Covered Executive may obtain a
further review by the Plan Administrator. If the Covered Executive does not receive a notice regarding his or her claim within these time periods, the claim will be considered denied. 

If the Covered Executive disagrees with the Plan Administrator’s decision, in whole or in part, the Covered Executive has 60 days
following receipt of written notice from the Plan Administrator to request a review in writing. The request must describe the reasons why the Covered Executive believes the denial was wrong and whatever evidence the Covered Executive believes
supports his or her position. If the Covered Executive wishes to examine any Company documents, he or she must request an examination and specify the documents requested. 

  
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 Within 60 days following a request for review, the Plan Administrator will send the Covered
Executive its written decision specifying the reasons for the decision, including the pertinent Plan provisions upon which it is based. This decision shall be final and binding. 

If special circumstances require an extension of time for the Plan Administrator to render a decision, the Plan Administrator will send the
Covered Executive a written notice of the extension prior to the commencement of the extension and will explain the reasons for the delay. 

The Company, as Plan Administrator, has the exclusive discretionary authority to construe and interpret the Plan, to decide all questions of
eligibility for severance benefits under the Plan and to determine the amount of any such severance benefits, and its decisions on such matters are final and conclusive. Any interpretations or determinations made pursuant to such discretionary
authority will be upheld on judicial review, unless it is shown that the interpretation or determination was an abuse of discretion (i.e., arbitrary and capricious). 

9. Your Rights Under ERISA. As a participant in the Plan, a Covered Executive is entitled to certain rights and protection under the
Employee Retirement Income Security Act of 1974, as amended (“ERISA”). ERISA provides that all Plan participants shall be entitled to: 
  

	 	•	 	Examine, without charge, at the Plan Administrator’s office and at other specified locations, such as worksites, all documents governing the Plan, including a copy of the latest annual report (Form 5500 Series)
filed by the Plan with the U.S. Department of Labor. 

  

	 	•	 	Obtain, upon written request to the Plan Administrator, copies of documents governing the operation of the Plan, including a copy of the latest annual report (Form 5500 Series) and updated summary plan description. The
Administrator may make a reasonable charge for the copies. 

  

	 	•	 	Receive a summary of the Plan’s annual financial report. The Plan Administrator is required by law to furnish each participant with a copy of this summary annual report. 

In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the
employee benefit plan. The people who operate the Plan, called “fiduciaries” of the Plan, have a duty to do so prudently and in the interest of the Covered Executive and other Plan participants and beneficiaries. No one, including the
employer, or any other person, may fire the Covered Executive or otherwise discriminate against the Covered Executive in any way to prevent the Covered Executive from obtaining a welfare benefit or exercising his or her rights under ERISA. If the
Covered Executive’s claim for a welfare benefit is denied, in whole or in part, he or she must receive a written explanation of the reason for the denial. The Covered Executive has the right to have the Plan review and reconsider his or her
claim. 

  
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 Under ERISA, there are steps a Covered Executive can take to enforce the above rights. For
instance, if the Covered Executive requests materials from the Plan and does not receive them within 30 days, he or she may file suit in a Federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay
the Covered Executive up to $110 a day until he or she receives the materials, unless the materials were not sent because of reasons beyond the control of the Plan Administrator. 

If the Covered Executive has a claim tor benefits which is denied or ignored, in whole or in part, the Covered Executive may file suit in a
state or Federal court. In addition, if the Covered Executive disagrees with the Plan’s decision or lack thereof concerning the qualified status of a medical child support order, he or she may file suit in Federal court. If it should happen
that Plan fiduciaries misuse the Plan’s money, or if the Covered Executive is discriminated against for asserting his or her rights, the Covered Executive may seek assistance from the U.S. Department of Labor, or may file suit in a Federal
court. The court will decide who should pay court costs and legal fees. If the Covered Executive is successful, the court may order the person the Covered Executive has sued to pay these costs and fees. If the Covered Executive loses, the court may
order him or her to pay these costs and fees — for example, if the court finds the Covered Executive’s claim is frivolous. 
 If
the Covered Executive has any questions about the Plan, he or she should contact the Plan Administrator. If the Covered Executive has any questions about this statement or about his or her rights under ERISA, the Covered Executive should contact the
nearest office of the Pension and Welfare Benefits Administration, U.S. Department of Labor, listed in the telephone directory or the Division of Technical Assistance and Inquiries, Pension and Welfare Benefits Administration, U.S. Department of
Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210. 
 10. Additional Important Information. The name of the Plan is the
Amedisys Holding, L.L.C. Severance Plan for Key Executives. 
 The sponsor of the Plan is Amedisys Holding, L.L.C. and its employer
identification number is 36-4576454. The sponsor’s address and telephone number is 5959 South Sherwood Forest Boulevard, Baton Rouge, Louisiana 70816, (225) 292-2031. 

Amedisys Holding, L.L.C. also serves as the Plan Administrator under ERISA for the Plan, and can be contacted at 5959 South Sherwood Forest
Boulevard, Baton Rouge, Louisiana 70816, (225) 292-2031. 
 The agent for service of process for the Plan is Secretary, Amedisys
Holding, L.L.C., 5959 South Sherwood Forest Boulevard, Baton Rouge, Louisiana 70816, (225) 292-2031. 
 The Plan is an employee welfare
benefit plan providing severance pay and benefits as described in this Plan document. All Severance Benefits under the Plan shall be paid directly by the Company from its general assets, and the rights of an eligible employee to any benefits
hereunder shall not be superior to those of an unsecured general creditor of the Company. 

  
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 The Plan year shall be the calendar year. The Plan number is 1. 

Severance benefits under the Plan may not be assigned, transferred or pledged to a third party. 

11. At-Will Employment. No provision of the Plan is intended to provide any Covered Executive with any right to continue as an employee
or in any other capacity with the Company, for any specific period of time, or otherwise affect the right of the Company to terminate the employment or service of any individual at any time for any reason with or without cause. 

12. Amendment and Termination. The Company reserves the right in its discretion to terminate the Plan and to amend the Plan in any
manner at any time, subject to the prior approval of the Board and/or the Committee, as applicable. Any such action will be in writing and signed by the Chief Executive Officer or the Chief Human Resources Officer of the Company or such other
persons as he or she shall designate. Oral or other informal communications made by the Company or its representatives shall not give rise to any rights or benefits other than those contained in the Plan described herein, and such communications
will not diminish the Company’s rights to amend or terminate the Plan in any manner. 
 This document is executed as of this 17th day of December 2015. 
  

			
	AMEDISYS HOLDING, L.L.C.
		
	By:	 	AMEDISYS, INC.
		 	Its Sole Member and Manager
		
	By:	 	 /s/ Larry Pernosky

		 	Larry Pernosky
		 	Chief Human Resources Officer

  
 8EX-10.1

 FIFTH AMENDMENT 

TO 
 AMENDED AND RESTATED
LOAN AND SECURITY AGREEMENT 
 This FIFTH AMENDMENT TO AMENDED AND RESTATED LOAN AND SECURITY AGREEMENT (this “Amendment”) is
entered into as of December     , 2015, by and among OXFORD FINANCE LLC (“Oxford”) as collateral agent (in such capacity, “Collateral Agent”), the Lenders listed on Schedule 1.1 of the
Loan Agreement or otherwise a party thereto from time to time, including without limitation, Oxford in its capacity as a Lender, and SILICON VALLEY BANK, a California corporation (“SVB”) (in such capacity, each a
“Lender” and collectively, the “Lenders”), and RELYPSA, INC., a Delaware corporation (“Borrower”), whose address is 100 Cardinal Way, Redwood City, CA 94063. 

RECITALS 

A. Collateral Agent, Lenders and Borrower have entered into that certain Amended and Restated Loan and Security Agreement dated as of
May 30, 2014 (as the same has been and may from time to time be further amended, modified, supplemented or restated, the “Loan Agreement”). Lenders have extended credit to Borrower for the purposes permitted in the Loan
Agreement. 
 B. Borrower has requested that Collateral Agent and Lenders amend the Loan Agreement to (i) permit Borrower to
incur Indebtedness relating to surety bonds, (ii) modify the repayment schedule for the Term Loans, and (iii) make certain other revisions to the Loan Agreement as more fully set forth herein. 

C. Collateral Agent and Lenders have agreed to so amend certain provisions of the Loan Agreement, but only to the extent, in accordance
with the terms, subject to the conditions and in reliance upon the representations and warranties set forth below. 

AGREEMENT 

NOW, THEREFORE, in consideration of the foregoing recitals and other good and valuable consideration, the
receipt and adequacy of which is hereby acknowledged, and intending to be legally bound, the parties hereto agree as follows: 
 1.
Definitions. Capitalized terms used but not defined in this Amendment shall have the meanings given to them in the Loan Agreement. 

2. Amendments to Loan Agreement. 

2.1 Section 2.2 (Term Loans). Clause (3) of Section 2.2(b) of the Loan Agreement is amended in its entirety and replaced
with the following: 
 (3) a repayment schedule equal to thirty (30) months. 

2.2 Section 6.6 (Operating Accounts). Section 6.6(a) of the Loan Agreement is amended by adding the following sentence to the
end thereof: 

  
 1 

 Notwithstanding the foregoing, Borrower may maintain a deposit account with Wells Fargo Bank, N.A. so long as
(i) such deposit account is subject to a Control Agreement in form and substance satisfactory to Collateral Agent, (ii) such deposit account is used solely to facilitate the terms and conditions of a Direct Payment Services Agreement by
and between Borrower and PharmaMetrics, Inc., and (iii) the balance of such deposit account does not exceed One Million Dollars ($1,000,000.00) at any time. 

2.3 Section 13.1 (Definitions). The following terms in Section 13.1 of the Loan Agreement are hereby amended and restated as
follows: 
 “Amortization Date” is, with respect to any Term Loan, January 1, 2017. 

“Maturity Date” is, for each Term Loan, June 1, 2019. 

“Second Draw Period” is terminated as of the Fifth Amendment Date and notwithstanding anything to the contrary herein, no Term
B Loans shall be available under this Agreement. 
 2.4 Section 13.1 (Definitions). The following new clause (n) is hereby
added to the definition of “Permitted Indebtedness” in Section 13.1 of the Loan Agreement: 
 (n) Indebtedness consisting of
surety bonds in an aggregate amount not to exceed Two Hundred Fifty Thousand Dollars ($250,000.00) at any time, incurred in the ordinary course of business and not representing an obligation for borrowed money. 

2.5 Section 13.1 (Definitions). The following term and its definition are hereby added to Section 13.1 of the Loan Agreement
in the proper alphabetical order: 
 “Fifth Amendment Date” is December     , 2015. 

2.6 Section 13.1 (Definitions). The following term and its definition set forth in Section 13.1 of the Loan Agreement are
deleted in their entirety: 
 “Second Draw Milestone” 

3. Limitation of Amendments. 

3.1 The amendments set forth in Section 2, above, are effective for the purposes set forth herein and shall be limited precisely as
written and shall not be deemed to (a) be a consent to any amendment, waiver or modification of any other term or condition of any Loan Document, or (b) otherwise prejudice any right or remedy which Collateral Agent or any Lender may now
have or may have in the future under or in connection with any Loan Document. 
 3.2 This Amendment shall be construed in
connection with and as part of the Loan Documents and all terms, conditions, representations, warranties, covenants and agreements set forth in the Loan Documents, except as herein amended, are hereby ratified and confirmed and shall remain in full
force and effect. 

  
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 4. Representations and Warranties. To induce Collateral Agent and Lenders to enter into
this Amendment, Borrower hereby represents and warrants to Collateral Agent and Lenders as follows: 
 4.1 Immediately after
giving effect to this Amendment (a) the representations and warranties contained in the Loan Documents are true, accurate and complete in all material respects as of the date hereof (except to the extent such representations and warranties
relate to an earlier date, in which case they are true and correct as of such date), and (b) no Event of Default has occurred and is continuing; 

4.2 Borrower has the power and authority to execute and deliver this Amendment and to perform its obligations under the Loan Agreement,
as amended by this Amendment; 
 4.3 The organizational documents of Borrower most recently delivered to Collateral Agent and
Lenders remain true, accurate and complete and have not been amended, supplemented or restated, and are and continue to be in full force and effect; 

4.4 The execution and delivery by Borrower of this Amendment and the performance by Borrower of its obligations under the Loan
Agreement, as amended by this Amendment, have been duly authorized;  
 4.5 The execution and delivery by Borrower of this
Amendment and the performance by Borrower of its obligations under the Loan Agreement, as amended by this Amendment, do not and will not contravene (a) any law or regulation binding on or affecting Borrower, (b) any contractual restriction
with a Person binding on Borrower, (c) any order, judgment or decree of any court or other governmental or public body or authority, or subdivision thereof, binding on Borrower, or (d) the organizational documents of Borrower;  

4.6 The execution and delivery by Borrower of this Amendment and the performance by Borrower of its obligations under the Loan
Agreement, as amended by this Amendment, do not require any order, consent, approval, license, authorization or validation of, or filing, recording or registration with, or exemption by any governmental or public body or authority, or subdivision
thereof, binding on Borrower, except as already has been obtained or made; and 
 4.7 This Amendment has been duly executed and
delivered by Borrower and is the binding obligation of Borrower, enforceable against Borrower in accordance with its terms, except as such enforceability may be limited by bankruptcy, insolvency, reorganization, liquidation, moratorium or other
similar laws of general application and equitable principles relating to or affecting creditors’ rights. 
 5.
Integration. This Amendment and the Loan Documents represent the entire agreement about this subject matter and supersede prior negotiations or agreements. All prior agreements, understandings, representations, warranties, and negotiations
between the parties about the subject matter of this Amendment and the Loan Documents merge into this Amendment and the Loan Documents. 

  
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 6. Counterparts. This Amendment may be executed in any number of counterparts and all of
such counterparts taken together shall be deemed to constitute one and the same instrument. 
 7. Effectiveness. This Amendment shall
be deemed effective upon (a) the due execution and delivery to Collateral Agent and Lenders of this Amendment by each party hereto, (b) Borrower’s payment of an amendment fee in an amount equal to One Hundred Eighty-Five Thousand
Dollars ($185,000.00), to be shared between the Lenders in accordance with their respective Pro Rata Shares, and (c) Borrower’s payment of all Lenders’ Expenses incurred through the date of this Amendment. 

8. Governing Law. This Amendment and the rights and obligations of the parties hereto shall be governed by and construed in accordance
with the laws of the State of New York. 
 [Signature page follows.] 

  
 4 

 IN WITNESS WHEREOF, the parties hereto have
caused this Amendment to be duly executed and delivered as of the date first written above. 
  

			
	COLLATERAL AGENT:	  	BORROWER
		
	Oxford Finance LLC	  	Relypsa, Inc.

									
					
	By:	 	/s/ Mark Davis	 		 	By:	 	/s/ Ronald A. Krasnow
	Name:	 	Mark Davis	 		 	Name:	 	Ronald A. Krasnow
	Title:	 	Vice President - Finance, Secretary & Treasurer	 		 	Title:	 	Senior Vice President and General Counsel

 LENDERS: 
 Oxford Finance
LLC 

			
		
	By:	 	/s/ Mark Davis
	Name:	 	Mark Davis
	Title:	 	Vice President - Finance, Secretary & Treasurer

 Silicon Valley Bank 

			
		
	By:	 	/s/ Dennis He
	Name:	 	Dennis He
	Title:	 	Vice President

 [Signature Page to Fifth Amendment to Amended and Restated Loan and Security Agreement]

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