Changes in Carrying Value of Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands	12 Months Ended
Dec. 31, 2015	Dec. 31, 2014
Goodwill [Line Items]
Beginning balance	$ 9,415,295	$ 9,212,974
Acquisitions	97,093	221,514
Divestitures	(8,781)	(1,851)
Foreign currency and other adjustments	(16,294)	(17,342)
Goodwill impairment charges	(192,834)
Ending balance	9,294,479	9,415,295
U.S. dialysis and related lab services
Goodwill [Line Items]
Beginning balance	5,610,643	5,469,473
Acquisitions	21,910	143,021
Divestitures	(3,370)	(1,851)
Ending balance	5,629,183	5,610,643
HealthCare Partners (HCP)
Goodwill [Line Items]
Beginning balance	3,562,534	3,516,162
Acquisitions	29,910	48,649
Divestitures	(5,411)
Foreign currency and other adjustments		(2,277)
Goodwill impairment charges	(188,769)
Ending balance	3,398,264	3,562,534
Other-Ancillary services and strategic initiatives
Goodwill [Line Items]
Beginning balance	242,118	227,339
Acquisitions	45,273	29,844
Foreign currency and other adjustments	(16,294)	(15,065)
Goodwill impairment charges	(4,065)
Ending balance	$ 267,032	$ 242,118

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 20
-Section 50
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