EXHIBIT 3.3

                           CERTIFICATE OF AMENDMENT
                                      OF
                         CERTIFICATE OF INCORPORATION
                                      OF
                        TOTAL RENAL CARE HOLDINGS, INC.

Total Renal Care Holdings, Inc. (the "Corporation"), a corporation organized and
existing under and by virtue of the General Corporation Law of the State of
Delaware, does hereby certify:

     FIRST:  That the Corporation was originally incorporated under the name
Medical Ambulatory Care Delaware, Inc., and the date of the filing of the
Corporation's original Certificate of Incorporation with the Delaware Secretary
of State was April 4, 1994.

     SECOND: That the Board of Directors of the Corporation adopted a resolution
proposing and declaring advisable the following amendment to the Corporation's
Certificate of Incorporation.

          "NOW, THEREFORE, BE IT RESOLVED, that Article I of the Amended and
     Restated Certificate of Incorporation of the Corporation be amended so that
     such Article, as amended, shall be and read as follows:

             "The name of the corporation is DaVita Inc. (the "Corporation")."

     THIRD:  That the foregoing amendment was duly adopted by all of the duly
elected directors of the Corporation in accordance with the applicable
provisions of Section 242 of the General Corporation Law of the State of
Delaware.

     FOURTH: The foregoing amendment was duly adopted by a majority of the
outstanding shares of stock of the Corporation in accordance with the applicable
provisions of Section 242 of the General Corporation Law of the State of
Delaware and the Corporation's Certificate of Incorporation.

     IN WITNESS WHEREOF, the Corporation has caused this Certificate to be
signed by Steven J. Udicious, its Vice President, General Counsel and Secretary,
this 5th day of October, 2000.

                          TOTAL RENAL CARE HOLDINGS, INC.
                          a Delaware corporation

                          By: /s/ STEVEN J. UDICIOUS
                              ----------------------
                                  Steven J. Udicious
                                  Vice President, Secretary and General Counsel