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Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2017	Jun. 30, 2016	Jun. 30, 2017	Jun. 30, 2016
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 200,038	$ 180,381	$ 390,244	$ 349,736
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Depreciation and amortization	130,002	119,350	255,030	235,887
DMG
Segment Reporting Information [Line Items]
Depreciation and amortization	60,011	54,211	117,334	100,473
Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 10,025	$ 6,820	$ 17,880	$ 13,376

X

- 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=66902209&loc=d3e3602-108585

+ Details

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X

- 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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