v2.4.0.8

Segment Reporting - Additional Information (Detail) (USD $) In Thousands, unless otherwise specified	12 Months Ended									2 Months Ended	12 Months Ended
	Dec. 31, 2013 Segment	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2013 U.S. dialysis and related lab services	Dec. 31, 2012 U.S. dialysis and related lab services	Dec. 31, 2011 U.S. dialysis and related lab services	Dec. 31, 2013 Other-ancillary services and strategic initiatives	Dec. 31, 2012 Other-ancillary services and strategic initiatives	Dec. 31, 2011 Other-ancillary services and strategic initiatives	Dec. 31, 2012 HealthCare Partners (HCP)	Dec. 31, 2013 HealthCare Partners (HCP)	Dec. 31, 2012 HealthCare Partners (HCP)
Segment Reporting Information [Line Items]
Number of major lines of business	2
Depreciation and amortization expense	$ 373,107	$ 299,810	$ 247,966	$ 355,879	$ 310,375	$ 259,685	$ 14,502	$ 7,050	$ 4,540	$ 24,544	$ 158,356
Total amount of expenditures for property and equipment				$ 554,345	$ 524,180		$ 31,670	$ 18,502			$ 31,582	$ 7,464

X

- Definition

The aggregate expense recognized in the current period that allocates the cost of tangible assets, intangible assets, or depleting assets to periods that benefit from use of the assets.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 230

-SubTopic 10

-Section 45

-Paragraph 28

-Subparagraph (b)

-URI http://asc.fasb.org/extlink&oid=31042434&loc=d3e3602-108585

+ Details

Name:	us-gaap_DepreciationDepletionAndAmortization
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	duration

X

- Definition

Number of operating segments. An operating segment is a component of an enterprise: (a) that engages in business activities from which it may earn revenues and incur expenses (including revenues and expenses relating to transactions with other components of the same enterprise), (b) whose operating results are regularly reviewed by the enterprise's chief operating decision maker to make decisions about resources to be allocated to the segment and assess its performance, and (c) for which discrete financial information is available. An operating segment may engage in business activities for which it has yet to earn revenues, for example, start-up operations may be operating segments before earning revenues.

+ References

No definition available.

+ Details

Name:	us-gaap_NumberOfOperatingSegments
Namespace Prefix:	us-gaap_
Data Type:	xbrli:integerItemType
Balance Type:	na
Period Type:	duration

X

- Definition

The cash outflow for purchases of and capital improvements on property, plant and equipment (capital expenditures), software, and other intangible assets.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Glossary Investing Activities

-URI http://asc.fasb.org/extlink&oid=6516133



Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 230

-SubTopic 10

-Section 45

-Paragraph 13

-Subparagraph (c)

-URI http://asc.fasb.org/extlink&oid=31042434&loc=d3e3213-108585

+ Details

Name:	us-gaap_PaymentsToAcquireProductiveAssets
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration

X

- Details

Name:	us-gaap_SegmentReportingInformationLineItems
Namespace Prefix:	us-gaap_
Data Type:	xbrli:stringItemType
Balance Type:	na
Period Type:	duration