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Segment Reporting - Summary of Assets by Segment (Details) - USD ($)
$ in Thousands
Dec. 31, 2017
Dec. 31, 2016
ASSETS    
Consolidated assets $ 18,948,193 $ 18,755,776
Equity method and other investments 245,534 492,039
Property and equipment, net 3,149,213 2,864,121
U.S. dialysis and related lab services    
ASSETS    
Consolidated assets 11,776,042 11,108,386
Equity method and other investments 84,866 66,924
Other-Ancillary services and strategic initiatives    
ASSETS    
Consolidated assets 1,410,509 1,434,299
Equity method and other investments 160,668 425,115
DMG - Held for sale    
ASSETS    
Consolidated assets 5,761,642 6,213,091
Equity method and other investments 10,321 10,350
Non-US | Other-Ancillary services and strategic initiatives    
ASSETS    
Property and equipment, net $ 125,932 $ 96,396