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29 Operating costs and expenses (Details) - BRL (R$)
R$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Summary of operating costs and expenses [Line Items]      
Operating costs R$ (11,179,667) R$ (10,137,637) R$ (9,086,456)
Selling expenses (751,286) (803,404) (693,480)
Allowance for doubtful accounts (444,826) (128,099) (166,727)
Administrative expenses (1,051,181) (1,187,844) (996,877)
Total (13,426,960) (12,256,984) (10,943,540)
Bad debt expense, net of recoveries [member]      
Summary of operating costs and expenses [Line Items]      
Allowance for doubtful accounts (444,826) (128,099) (166,727)
Total (444,826) (128,099) (166,727)
Depreciation and amortization [member]      
Summary of operating costs and expenses [Line Items]      
Operating costs (1,882,259) (1,659,779) (1,276,444)
Selling expenses (59,201) (31,649) (17,272)
Administrative expenses (95,652) (88,666) (98,825)
Total (2,037,112) (1,780,094) (1,392,541)
Tax expenses [member]      
Summary of operating costs and expenses [Line Items]      
Administrative expenses (77,416) (73,205) (58,750)
Total (77,416) (73,205) (58,750)
Salaries, payroll charges and benefits [member]      
Summary of operating costs and expenses [Line Items]      
Operating costs (1,958,395) (1,938,265) (1,959,539)
Selling expenses (271,565) (270,549) (289,378)
Administrative expenses (257,829) (278,507) (254,284)
Total (2,487,789) (2,487,321) (2,503,201)
Pension plan obligations [member]      
Summary of operating costs and expenses [Line Items]      
Operating costs (37,281) (49,564) (25,066)
Selling expenses (5,059) (6,848) (3,602)
Administrative expenses (116,941) (138,207) (141,758)
Total (159,281) (194,619) (170,426)
Construction costs [member]      
Summary of operating costs and expenses [Line Items]      
Operating costs (3,630,139) (2,881,394) (2,739,657)
Total (3,630,139) (2,881,394) (2,739,657)
General supplies [member]      
Summary of operating costs and expenses [Line Items]      
Operating costs (244,054) (259,401) (238,034)
Selling expenses (5,471) (10,332) (6,391)
Administrative expenses (14,237) (3,216) (4,881)
Total (263,762) (272,949) (249,306)
Treatment supplies [member]      
Summary of operating costs and expenses [Line Items]      
Operating costs (338,756) (310,380) (265,146)
Total (338,756) (310,380) (265,146)
Outsourced services [member]      
Summary of operating costs and expenses [Line Items]      
Operating costs (1,251,839) (1,250,890) (996,477)
Selling expenses (290,512) (360,190) (273,470)
Administrative expenses (230,054) (197,357) (204,728)
Total (1,772,405) (1,808,437) (1,474,675)
Electricity [member]      
Summary of operating costs and expenses [Line Items]      
Operating costs (1,214,831) (1,140,160) (956,840)
Selling expenses (1,200) (1,333) (1,154)
Administrative expenses (1,359) (1,436) (1,363)
Total (1,217,390) (1,142,929) (959,357)
General expenses [member]      
Summary of operating costs and expenses [Line Items]      
Operating costs (622,113) (647,804) (629,253)
Selling expenses (118,278) (122,503) (102,213)
Administrative expenses (257,693) (407,250) (232,288)
Total R$ (998,084) R$ (1,177,557) R$ (963,754)