927066--3/6/2006--DAVITA

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If the average rates that commercial payors pay us decline, then our revenues, earnings and cash flows would be substantially reduced. If the number of patients with higher-paying commercial insurance declines, then our revenues, earnings and cash flows would be substantially reduced. Future declines, or the lack of further increases, in Medicare payment rates would reduce our revenues, earnings and cash flows. Changes in the structure of, and payment rates under, the Medicare ESRD program could substantially reduce our revenues, earnings and cash flows. Changes in state Medicaid programs or payment rates could reduce our revenues, earnings and cash flows. Changes in clinical practices and payment rates or rules for EPO and other pharmaceuticals could substantially reduce our revenues, earnings and cash flows. Adverse developments with respect to EPO and the use and marketing of Aranesp could materially reduce our earnings and cash flows and affect our ability to care for our patients. The investigation related to the subpoena we received on March 4, 2005 from the U.S. Attorney s Office for the Eastern District of Missouri could result in substantial penalties against us. The investigation related to the subpoena we received on October 25, 2004 from the U.S. Attorney s Office for the Eastern District of New York could result in substantial penalties against us. The pending federal review related to the subpoena we received in May 2002 from the U.S. Attorney s Office for the Eastern District of Pennsylvania could result in substantial penalties against us. If we fail to adhere to all of the complex government regulations that apply to our business, we could suffer severe consequences that would substantially reduce our revenues, earnings and cash flows. If our joint ventures were found to violate the law, we could suffer severe consequences that would have a material adverse effect on our revenues, earnings and cash flows. We may be subject to liability claims for damages and other expenses not covered by insurance that could reduce our earnings and cash flows. If businesses we acquire have liabilities that we are not aware of, we could suffer severe consequences that would substantially reduce our revenues, earnings and cash flows. If a significant number of physicians were to cease referring patients to our dialysis centers, whether due to regulatory or other reasons, then our revenues, earnings and cash flows would be substantially reduced. The level of our current and future debt could have an adverse impact on our business. We will require a significant amount of cash to service our indebtedness. Our ability to generate cash depends on many factors beyond our control. If the current shortage of skilled clinical personnel continues or if we experience a higher than normal turnover rate for DVA Renal Healthcare employees during integration, we may experience disruptions in our business operations and increases in operating expenses. The acquisition of DVA Renal Healthcare was significantly larger than any other acquisition we have made to date. The integration of DVA Renal Healthcare centers into our operations is significant and we may not realize anticipated benefits. If DVA Renal Healthcare does not comply with its corporate integrity agreement, or DVA Renal Healthcare otherwise has failed or fails to comply with applicable government regulations to its operations, we could be subject to additional penalties and otherwise may be materially harmed. We have assumed substantially all of DVA Renal Healthcare s liabilities, including contingent liabilities. If these liabilities are greater than expected, or if there are unknown DVA Renal Healthcare obligations, our business could be materially and adversely affected. The integration of DVA Renal Healthcare and the realization of cost savings will require us to make significant expenditures. If we lose the services of a significant number of DVA Renal Healthcare s medical directors, our results of operations could be harmed. Our alliance and product supply agreement with Gambro Renal Products Inc. will limit our ability to achieve cost savings with respect to products and equipment we are required to purchase under this agreement. Our ability to effectively provide the services we offer could be negatively impacted if certain of our suppliers are unable to meet our needs which could substantially reduce our revenues, earnings and cash flows.

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927066--3/6/2006--DAVITA_INC