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Condensed consolidating financial statements - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2017
Sep. 30, 2016
Sep. 30, 2017
Sep. 30, 2016
Cash flows from operating activities:        
Net (loss) income $ (172,034) $ 612,150 $ 489,876 $ 844,812
Changes in operating assets and liabilities and non-cash items included in net income     1,074,663 636,450
Net cash provided by operating activities     1,564,539 1,481,262
Cash flows from investing activities:        
Additions of property and equipment (240,889) (216,616) (639,829) (575,243)
Acquisitions     (726,538) (497,331)
Proceeds from asset and business sales     92,529 18,991
Proceeds (purchases) from investment sales and other items, net     166,605 (203,659)
Net cash used in investing activities     (1,107,233) (1,257,242)
Cash flows from financing activities:        
Long-term debt and related financing costs, net     (108,463) (98,724)
Intercompany borrowing (payments)     0 0
Other items     (421,369) (709,252)
Net cash used in financing activities     (529,832) (807,976)
Effect of exchange rate changes on cash     5,449 (1,664)
Net decrease in cash and cash equivalents     (67,077) (585,620)
Cash and cash equivalents at beginning of period     913,187 1,499,116
Cash and cash equivalents at end of period 846,110 913,496 846,110 913,496
Consolidating adjustments        
Cash flows from operating activities:        
Net (loss) income 160,969 (840,027) (563,330) (1,155,137)
Changes in operating assets and liabilities and non-cash items included in net income     563,330 1,155,137
Net cash provided by operating activities     0 0
Cash flows from investing activities:        
Additions of property and equipment     0 0
Acquisitions     0 0
Proceeds from asset and business sales     0 0
Proceeds (purchases) from investment sales and other items, net     0 0
Net cash used in investing activities     0 0
Cash flows from financing activities:        
Long-term debt and related financing costs, net     0 0
Intercompany borrowing (payments)     0 0
Other items     0 0
Net cash used in financing activities     0 0
Effect of exchange rate changes on cash     0 0
Net decrease in cash and cash equivalents     0 0
Cash and cash equivalents at beginning of period     0 0
Cash and cash equivalents at end of period 0 0 0 0
DaVita Inc. | Reportable Legal Entities        
Cash flows from operating activities:        
Net (loss) income (214,476) 571,332 360,222 722,148
Changes in operating assets and liabilities and non-cash items included in net income     (291,657) (586,804)
Net cash provided by operating activities     68,565 135,344
Cash flows from investing activities:        
Additions of property and equipment     (94,385) (81,785)
Acquisitions     0  
Proceeds from asset and business sales     0 0
Proceeds (purchases) from investment sales and other items, net     123,894 (236,150)
Net cash used in investing activities     29,509 (317,935)
Cash flows from financing activities:        
Long-term debt and related financing costs, net     (92,721) (73,889)
Intercompany borrowing (payments)     197,983 283,709
Other items     (305,630) (589,964)
Net cash used in financing activities     (200,368) (380,144)
Effect of exchange rate changes on cash     0 0
Net decrease in cash and cash equivalents     (102,294) (562,735)
Cash and cash equivalents at beginning of period     549,921 1,186,636
Cash and cash equivalents at end of period 447,627 623,901 447,627 623,901
Guarantor subsidiaries | Reportable Legal Entities        
Cash flows from operating activities:        
Net (loss) income (243,436) 504,852 249,554 611,204
Changes in operating assets and liabilities and non-cash items included in net income     606,783 228,991
Net cash provided by operating activities     856,337 840,195
Cash flows from investing activities:        
Additions of property and equipment     (305,261) (248,339)
Acquisitions     (627,324) (458,556)
Proceeds from asset and business sales     90,533 24,608
Proceeds (purchases) from investment sales and other items, net     (6,472) (12,825)
Net cash used in investing activities     (848,524) (695,112)
Cash flows from financing activities:        
Long-term debt and related financing costs, net     (10,394) (20,684)
Intercompany borrowing (payments)     (40,411) (188,247)
Other items     (1,432) (9,740)
Net cash used in financing activities     (52,237) (218,671)
Effect of exchange rate changes on cash     0 0
Net decrease in cash and cash equivalents     (44,424) (73,588)
Cash and cash equivalents at beginning of period     59,192 109,357
Cash and cash equivalents at end of period 14,768 35,769 14,768 35,769
Non- Guarantor subsidiaries | Reportable Legal Entities        
Cash flows from operating activities:        
Net (loss) income 124,909 375,993 443,430 666,597
Changes in operating assets and liabilities and non-cash items included in net income     196,207 (160,874)
Net cash provided by operating activities     639,637 505,723
Cash flows from investing activities:        
Additions of property and equipment     (240,183) (245,119)
Acquisitions     (99,214) (38,775)
Proceeds from asset and business sales     1,996 (5,617)
Proceeds (purchases) from investment sales and other items, net     49,183 45,316
Net cash used in investing activities     (288,218) (244,195)
Cash flows from financing activities:        
Long-term debt and related financing costs, net     (5,348) (4,151)
Intercompany borrowing (payments)     (157,572) (95,462)
Other items     (114,307) (109,548)
Net cash used in financing activities     (277,227) (209,161)
Effect of exchange rate changes on cash     5,449 (1,664)
Net decrease in cash and cash equivalents     79,641 50,703
Cash and cash equivalents at beginning of period     304,074 203,123
Cash and cash equivalents at end of period $ 383,715 $ 253,826 $ 383,715 $ 253,826