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Segment reporting - Summary of Assets by Segment (Detail) - USD ($) $ in Thousands | Sep. 30, 2018 | Dec. 31, 2017
--- | --- | ---
ASSETS |  |
Total assets | $ 19,357,789 | $ 18,948,193
U.S. dialysis and related lab services |  |
ASSETS |  |
Total assets | 12,101,111 | 11,776,042
Other—Ancillary services and strategic initiatives |  |
ASSETS |  |
Total assets | 1,308,892 | 1,410,509
DMG held for sale |  |
ASSETS |  |
Total assets | $ 5,947,786 | $ 5,761,642

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