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Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2015 | Dec. 31, 2014 | Dec. 31, 2013
Segment Reporting Information [Line Items] |  |  |
Expenditures for property and equipment | $ 707,998 | $ 641,330 | $ 617,597
U.S. dialysis and related lab services |  |  |
Segment Reporting Information [Line Items] |  |  |
Expenditures for property and equipment | 584,513 | 560,610 | 554,345
HealthCare Partners (HCP) |  |  |
Segment Reporting Information [Line Items] |  |  |
Expenditures for property and equipment | 66,800 | 27,885 | 31,582
Other-Ancillary services and strategic initiatives |  |  |
Segment Reporting Information [Line Items] |  |  |
Expenditures for property and equipment | $ 56,685 | $ 52,835 | $ 31,670

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- Definition The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed 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=56944662&loc=d3e3213-108585 + Details
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