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Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017	Jun. 30, 2018
Goodwill [Roll Forward]
Beginning balance			$ 6,610,279	$ 6,015,375	$ 6,015,375
Acquisitions			106,220		617,032
Divestitures			(15,384)		(32,386)
Goodwill impairment charges	$ (3,106)	$ (10,498)	(3,106)	(34,696)	(36,196)
Foreign currency and other adjustments			(19,450)		46,454
Ending balance	6,678,559		6,678,559		6,610,279
Goodwill						$ 6,712,837
Accumulated impairment charges						(34,278)
Total goodwill by reportable segments	6,678,559		6,610,279	6,015,375	6,015,375	6,678,559
U.S. dialysis and related lab services
Goodwill [Roll Forward]
Beginning balance			6,144,761	5,691,587	5,691,587
Acquisitions			6,357		485,434
Divestitures			(218)		(32,260)
Goodwill impairment charges			0		0
Foreign currency and other adjustments			0		0
Ending balance	6,150,900		6,150,900		6,144,761
Goodwill						6,150,900
Accumulated impairment charges						0
Total goodwill by reportable segments	6,150,900		6,144,761	5,691,587	5,691,587	6,150,900
Other—Ancillary services and strategic initiatives
Goodwill [Roll Forward]
Beginning balance			465,518	323,788	323,788
Acquisitions			99,863		131,598
Divestitures			(15,166)		(126)
Goodwill impairment charges			(3,106)		(36,196)
Foreign currency and other adjustments			(19,450)		46,454
Ending balance	527,659		527,659		465,518
Goodwill						561,937
Accumulated impairment charges						(34,278)
Total goodwill by reportable segments	$ 527,659		$ 465,518	$ 323,788	$ 323,788	$ 527,659

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- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount of foreign currency translation gain (loss) which increases (decreases) an asset representing future economic benefits from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount of loss from the write-down of an asset representing the future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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