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Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 241,534	$ 184,405	$ 473,977	$ 398,940
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	194,188	152,233	383,238	325,761
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Expenditures for property and equipment	25,047	11,289	37,392	24,508
DMG held for sale
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 22,299	$ 20,883	$ 53,347	$ 48,671

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- 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://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 13
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=109223946&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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- Details

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