EXHIBIT 23.3
 
                            CONSENT OF INDEPENDENT 
                         CERTIFIED PUBLIC ACCOUNTANTS
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The Board of Directors
Total Renal Care Holdings, Inc.:


We consent to incorporation herein by reference of our reports dated July 8,
1994, relating to the consolidated balance sheets of Total Renal Care, Inc. and
subsidiaries as of May 31, 1994 and 1993, and the related consolidated
statements of income and retained earnings, and cash flows for each of the years
in the three-year period ended May 31, 1994 and all related financial statement
schedules and the consolidated statements of income, stockholders' equity, and
cash flows of Total Renal Care Holdings, Inc. and subsidiaries for the year
ended May 31, 1994 and the related financial statement schedule, which reports
appear in the registration statement No. 33-79770 on Form S-1 of Total Renal
Care, Inc. and Medical Ambulatory Care, Inc. and the December 31, 1996 annual
report on Form 10-K of Total Renal Care Holdings, Inc.

Our reports which appear in the registration statement No. 33-79770 on Form S-1
of Total Renal Care, Inc. and Medical Ambulatory Care, Inc. refer to a change in
the method of accounting for income taxes effective June 1, 1993.


KPMG Peat Marwick LLP


Seattle, Washington
August 29, 1997