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Summary of Depreciation and Amortization Expense 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] |  |  |
Depreciation and amortization | $ 638,024 | $ 590,935 | $ 528,737
U.S. dialysis and related lab services |  |  |
Segment Reporting Information [Line Items] |  |  |
Depreciation and amortization | 438,238 | 402,767 | 355,879
HealthCare Partners (HCP) |  |  |
Segment Reporting Information [Line Items] |  |  |
Depreciation and amortization | 174,118 | 169,485 | 158,356
Other-Ancillary services and strategic initiatives |  |  |
Segment Reporting Information [Line Items] |  |  |
Depreciation and amortization | $ 25,668 | $ 18,683 | $ 14,502

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- Definition The current period expense charged against earnings on long-lived, physical assets not used in production, and which are not intended for resale, to allocate or recognize the cost of such assets over their useful lives; or to record the reduction in book value of an intangible asset over the benefit period of such asset; or to reflect consumption during the period of an asset that is not used in production. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 360 -SubTopic 10 -Section 50 -Paragraph 1 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=6391035&loc=d3e2868-110229 Reference 2: 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=56944662&loc=d3e3602-108585 + Details
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- Definition Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table. + References No definition available. + Details
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