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Long-term debt - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Mar. 28, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Debt Instrument, Maturity Date	Jun. 28, 2019
Unrealized gains (losses) on interest rate cap agreements	$ 1,050	$ (3,188)
Weighted average effective interest rate on senior secured credit facilities	4.98%
Weighted average effective interest rate during quarter	4.87%
Fixed interest rate	51.34%
U.S. dialysis and related lab services
Debt Instrument [Line Items]
Letters of credit outstanding	$ 22,351
DMG
Debt Instrument [Line Items]
Letters of credit outstanding	211
Revolving Credit Facility
Debt Instrument [Line Items]
Undrawn revolving credit facilities	1,000,000
Letter of Credit
Debt Instrument [Line Items]
Letters of credit outstanding	14,355
Interest Rate Cap Agreements Effective September 30, 2016
Debt Instrument [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000
Derivative, effective date	Sep. 30, 2016
Derivative, expiration date	Jun. 30, 2018
Debt expense recognized	$ 2,070
Interest Rate Cap Agreements Effective June 29, 2018
Debt Instrument [Line Items]
Notional amounts of interest rate agreements	$ 3,500,000
Derivative, effective date	Jun. 29, 2018
Derivative, expiration date	Jun. 30, 2020
Fair value of assets	$ 2,446
Unrealized gains (losses) on interest rate cap agreements	$ 1,414
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective September 30, 2016
Debt Instrument [Line Items]
LIBOR variable rate	3.50%
London Interbank Offered Rate (LIBOR) | Interest Rate Cap Agreements Effective June 29, 2018
Debt Instrument [Line Items]
LIBOR variable rate	3.50%
Term Loan A
Debt Instrument [Line Items]
Mandatory principal payments	$ 25,000
Capped portion of interest payments	$ 750,000			$ 775,000
Term Loan A | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest rate margin	2.00%
Term Loan A-2
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity			$ 995,000
Proceeds from Long-term Lines of Credit	$ 452,000
Debt Instrument, Unused Borrowing Capacity, Amount			$ 543,000
Capped portion of interest payments	$ 452,000			0
Term Loan A-2 | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest rate margin	1.00%
Term Loan B
Debt Instrument [Line Items]
Mandatory principal payments	$ 8,750
Capped portion of interest payments	$ 3,368,750			$ 3,377,500
Term Loan B | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR plus interest rate margin	2.75%
Term Loan B | London Interbank Offered Rate (LIBOR) | Maximum
Debt Instrument [Line Items]
LIBOR plus interest rate margin	3.50%
Term Loan A subject to interest rate caps
Debt Instrument [Line Items]
Capped portion of interest payments	$ 131,250
Term Loan A subject to uncapped portion of variability of LIBOR
Debt Instrument [Line Items]
Capped portion of interest payments	$ 618,750
Senior Secured Credit Facilities
Debt Instrument [Line Items]
Weighted average effective interest rate on senior secured credit facilities	4.67%

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Amount of the total principal payments made during the annual reporting period.

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