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Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended
Jun. 30, 2016
Jun. 30, 2015
Jun. 30, 2016
Jun. 30, 2015
Segment Reporting Information [Line Items]        
Depreciation and amortization $ 180,381 $ 158,843 $ 349,736 $ 312,632
U.S. Dialysis And Related Lab Services        
Segment Reporting Information [Line Items]        
Depreciation and amortization 119,350 109,461 235,887 214,453
HealthCare Partners (HCP)        
Segment Reporting Information [Line Items]        
Depreciation and amortization 54,211 43,088 100,473 86,367
Other Segments        
Segment Reporting Information [Line Items]        
Depreciation and amortization $ 6,820 $ 6,294 $ 13,376 $ 11,812