Segment Reporting - Additional Information (Details) $ in Thousands	12 Months Ended
Dec. 31, 2017 segment	Dec. 31, 2016 USD ($)
Segment Reporting Information [Line Items]
Operating divisions \| segment	2
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Segment assets, misstatement adjustment		$ 338,963
Other-Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Segment assets, misstatement adjustment		$ (338,963)

Number of operating segments. An operating segment is a component of an enterprise: (a) that engages in business activities from which it may earn revenues and incur expenses (including revenues and expenses relating to transactions with other components of the same enterprise), (b) whose operating results are regularly reviewed by the enterprise's chief operating decision maker to make decisions about resources to be allocated to the segment and assess its performance, and (c) for which discrete financial information is available. An operating segment may engage in business activities for which it has yet to earn revenues, for example, start-up operations may be operating segments before earning revenues.

No definition available.

Name:	us-gaap_NumberOfOperatingSegments
Namespace Prefix:	us-gaap_
Data Type:	xbrli:integerItemType
Balance Type:	na
Period Type:	duration