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