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Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended
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Sep. 30, 2018 | Sep. 30, 2017 | Sep. 30, 2018 | Sep. 30, 2017
Segment Reporting Information [Line Items] |  |  |  |
Expenditures for property and equipment | $ 231,682 | $ 240,889 | $ 705,659 | $ 639,829
U.S. dialysis and related lab services |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |
Expenditures for property and equipment | 214,728 | 207,472 | 603,186 | 538,620
Other—Ancillary services and strategic initiatives |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |
Expenditures for property and equipment | 5,019 | 9,135 | 37,191 | 28,256
DMG held for sale |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |
Expenditures for property and equipment | $ 11,935 | $ 24,282 | $ 65,282 | $ 72,953

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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. + Details
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- Details
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- Details
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