fresenius se  co kgaa has again cut its guidance for the year foreseeing a sharper fall in earnings as macroeconomic pressures and a struggling north america business at subsidiary fresenius medical care  co kgaa weighed on thirdquarter performance the german healthcare company now expects a fall of around 10 in group net profit in 2022 at constant currency from previous guidance of a singledigit decline sales growth is still expected in the low to midsingle digits fresenius said sunday the lower guidance comes amid expected lower contributions from dialysiscare subsidiary fmc where net profit is now expected to fall more steeply in the percent range of the high teens to mid20s delays to improvements in the north american healthcare services operations are weighing on earnings as are general macroeconomic pressures fmc said revenue is still expected to grow moderately for the year in the third quarter freseniuss net profit fell 19 at constant currency excluding recent acquisitions to 371 million euros 3697 million amid higher labor costs at fmcs us business as well as general cost inflation the company said earnings before interest and taxes and before special items fell 17 to eur949 million with the operating margin contracting to 91 the company said sales grew organically by 4 to eur1046 billion fresenius said at fmc in which fresenius holds a stake of around 32 quarterly sales rose 3 to eur51 billion while net profit before special items fell 24 to eur230 million and operating profit before special items fell 17 to eur472 million the company said while it is disappointing that the execution against our north america recovery plan is delayed we are confident that the intensified efforts will improve the performance fmcs chief financial officer helen giza said in july fresenius cut its sales outlook for the year as a result of weak business performance at fmc and said it expected a decline in earnings for the year having previously guided for an increase further ahead macroeconomic factors remain a major headwind and source of uncertainty fresenius said pointing to cost inflation labor shortages and potential disruption to energy supplies the russiaukraine war also directly and indirectly affects the company business valued at a eur24 million drag on the bottom line in the first nine months of the year the company said fresenius will continue to closely monitor the potential further consequences of the overall heightened volatility and muted visibility including balance sheet valuations the company said