Condensed consolidating financial statements - Condensed Consolidating Statements of Cash Flows (Detail) - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2018	Mar. 31, 2017
Cash flows from operating activities:
Net income	$ 225,229	$ 500,285
Changes in operating assets and liabilities and non-cash items included in net income	137,310	364,886
Net cash provided by operating activities	362,539	865,171
Cash flows from investing activities:
Additions of property and equipment	(232,443)	(214,535)
Acquisitions	(16,582)	(77,236)
Proceeds from asset and business sales	18,535	46,612
Proceeds (purchases) from investment sales and other items, net	30,362	(4,828)
Net cash used in investing activities	(200,128)	(249,987)
Cash flows from financing activities:
Long-term debt and related financing costs, net	104,673	(36,141)
Intercompany borrowing (payments)	0	0
Other items	(327,220)	(22,796)
Net cash used in financing activities	(222,547)	(58,937)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	6,668	2,820
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(53,468)	559,067
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	518,920	683,463
Cash, cash equivalents and restricted cash of continuing operations at end of the period	447,618	1,218,037
Consolidating adjustments
Cash flows from operating activities:
Net income	(207,613)	(557,116)
Changes in operating assets and liabilities and non-cash items included in net income	207,613	557,116
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, cash equivalents and restricted cash	0	0
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0	0
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	0	0
Cash, cash equivalents and restricted cash of continuing operations at end of the period	0
DaVita Inc. \| Reportable Legal Entities
Cash flows from operating activities:
Net income	178,686	447,697
Changes in operating assets and liabilities and non-cash items included in net income	(82,391)	(149,627)
Net cash provided by operating activities	96,295	298,070
Cash flows from investing activities:
Additions of property and equipment	(27,356)	(30,580)
Acquisitions	0
Proceeds from asset and business sales	0	0
Proceeds (purchases) from investment sales and other items, net	31,665	(54,150)
Net cash used in investing activities	4,309	(84,730)
Cash flows from financing activities:
Long-term debt and related financing costs, net	116,307	(27,504)
Intercompany borrowing (payments)	47,394	338,984
Other items	(291,562)	3,330
Net cash used in financing activities	(127,861)	314,810
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(27,257)	528,150
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	150,307	549,921
Cash, cash equivalents and restricted cash of continuing operations at end of the period	123,050	1,078,071
Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from operating activities:
Net income	141,117	394,501
Changes in operating assets and liabilities and non-cash items included in net income	32,484	(142,597)
Net cash provided by operating activities	173,601	251,904
Cash flows from investing activities:
Additions of property and equipment	(125,375)	(133,909)
Acquisitions	(4,417)	(70,237)
Proceeds from asset and business sales	18,535	46,612
Proceeds (purchases) from investment sales and other items, net	(762)	(1,951)
Net cash used in investing activities	(112,019)	(159,485)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(3,377)	(4,616)
Intercompany borrowing (payments)	(49,783)	(71,541)
Other items	(2,200)	(799)
Net cash used in financing activities	(55,360)	(76,956)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	0	0
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	6,222	15,463
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	9,384	8,687
Cash, cash equivalents and restricted cash of continuing operations at end of the period	9,421	8,712
Non- Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from operating activities:
Net income	113,039	215,203
Changes in operating assets and liabilities and non-cash items included in net income	(20,396)	99,994
Net cash provided by operating activities	92,643	315,197
Cash flows from investing activities:
Additions of property and equipment	(79,712)	(50,046)
Acquisitions	(12,165)	(6,999)
Proceeds from asset and business sales	0	0
Proceeds (purchases) from investment sales and other items, net	(541)	51,273
Net cash used in investing activities	(92,418)	(5,772)
Cash flows from financing activities:
Long-term debt and related financing costs, net	(8,257)	(4,021)
Intercompany borrowing (payments)	2,389	(267,443)
Other items	(33,458)	(25,327)
Net cash used in financing activities	(39,326)	(296,791)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	6,668	2,820
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(32,433)	15,454
Cash, cash equivalents and restricted cash of continuing operations at beginning of the year	359,229	124,855
Cash, cash equivalents and restricted cash of continuing operations at end of the period	315,147	131,254
Discontinued Operations
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	17,834	24,493
Discontinued Operations \| Consolidating adjustments
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0	0
Discontinued Operations \| DaVita Inc. \| Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0	0
Discontinued Operations \| Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	6,185	15,438
Discontinued Operations \| Non- Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	11,649	9,055
Continuing Operations
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(71,302)	534,574
Continuing Operations \| Consolidating adjustments
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	0
Continuing Operations \| DaVita Inc. \| Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	(27,257)	528,150
Continuing Operations \| Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	37	25
Continuing Operations \| Non- Guarantor subsidiaries \| Reportable Legal Entities
Cash flows from financing activities:
Net (decrease) increase in cash, cash equivalents and restricted cash from continuing operations	$ (44,082)	$ 6,399

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