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Summary of Expenditures for Property and Equipment 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]
Expenditures for property and equipment	$ 184,405	$ 185,440	$ 398,940	$ 358,627
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	152,233	150,932	325,761	284,380
DMG
Segment Reporting Information [Line Items]
Expenditures for property and equipment	20,883	18,098	48,671	38,243
Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 11,289	$ 16,410	$ 24,508	$ 36,004

X

- 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=66902209&loc=d3e3213-108585

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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

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