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Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 232,443	$ 214,535
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	189,049	173,528
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Expenditures for property and equipment	12,345	13,219
DMG held for sale
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 31,049	$ 27,788

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
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 13
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=98514028&loc=d3e3213-108585

+ Details

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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

No definition available.

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