EXHIBIT 23.4 CONSENT OF INDEPENDENT ACCOUNTANTS We hereby consent to the incorporation by reference in this Registration Statement on Form S-8 of our report dated March 14, 1997, on the financial statements of South Brooklyn Nephrology Center, Inc. (a Subchapter S Corporation) for the years ended December 31, 1996 and 1995 which appears on page F-1 of Total Renal Care Holdings, Inc.'s Current Report on Form 8-K dated January 22, 1998. /s/ MAIER, MARKEY & MENASHI LLP MAIER MARKEY & MENASHI LLP Larchmont, New York February 24, 1998