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Acquisitions and divestitures - Aggregate Purchase Cost Allocations for Acquisitions (Detail) - USD ($) $ in Thousands | Sep. 30, 2018 | Dec. 31, 2017 | Dec. 31, 2016
--- | --- | --- | ---
Business Acquisition [Line Items] |  |  |
Goodwill | $ 6,702,659 | $ 6,610,279 | $ 6,015,375
Dialysis and other businesses |  |  |
Business Acquisition [Line Items] |  |  |
Current assets | 10,183 |  |
Property and equipment | 5,654 |  |
Intangible and other long-term assets | 3,672 |  |
Goodwill | 135,654 |  |
Current liabilities | (12,139) |  |
Long-term liabilities | (212) |  |
Noncontrolling interests | (11,947) |  |
Aggregate purchase price | $ 130,865 |  |

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