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Equity Method and Other Investments - Additional Information (Details) - USD ($) $ in Thousands |  | 3 Months Ended | 12 Months Ended
--- | --- | --- | ---
Aug. 01, 2016 | Mar. 31, 2019 | Dec. 31, 2018 | Sep. 30, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Noncontrolling Interest [Line Items] |  |  |  |  |  |  |  |  |  |
Equity investment (loss) income |  |  |  |  |  |  |  | $ (4,484) | $ (8,640) | $ 16,874
Equity Method Investment, Additional Information |  |  |  | During the third quarter of 2018, the investors in the APAC JV jointly agreed to a six-month deferral of the subscribed incremental capital contributions originally scheduled for August 1, 2018 based upon revised assessments of the capital needs of the joint venture. |  |  |  |  |  |
Number Of Partnerships |  |  | 22 |  |  |  |  | 22 |  |
Cost-method total aggregate carrying amount of equity investments |  |  | $ 12,386 |  |  |  |  | $ 12,386 |  |
Valuation Adjustment |  |  |  |  |  |  |  | 0 |  |
APAC JV - Deconsolidated Noncontrolling Entity |  |  |  |  |  |  |  |  |  |
Noncontrolling Interest [Line Items] |  |  |  |  |  |  |  |  |  |
Equity investment (loss) income |  |  | $ 1,530 | $ 5,995 |  | $ 6,293 |  | $ (4,484) | $ (8,640) | $ 16,874
Non-cash other than temporary impairment losses |  |  |  |  | $ 280,066 |  |  |  |  |
Voting Interest, in percents |  |  | 40.00% |  |  |  |  | 40.00% |  |
Current economic interest in the APAC JV, Owned by Noncontrolling Investors |  |  | 26.70% |  |  |  |  | 26.70% |  |
Company and Restricted Subsidiaries(1) |  |  |  |  |  |  |  |  |  |
Noncontrolling Interest [Line Items] |  |  |  |  |  |  |  |  |  |
Voting Interest, in percents |  |  | 60.00% |  |  |  |  | 60.00% |  |
Current economic interest in the APAC JV, Owned by the Parent Company |  |  | 73.30% |  |  |  |  | 73.30% |  |
Ownership percentage by Parent |  |  | 73.30% |  |  |  |  | 73.30% |  |
Minimum |  |  |  |  |  |  |  |  |  |
Noncontrolling Interest [Line Items] |  |  |  |  |  |  |  |  |  |
Current economic interest in the APAC JV, Owned by the Parent Company |  |  | 30.00% |  |  |  |  | 30.00% |  |
Ownership percentage by Parent |  |  | 30.00% |  |  |  |  | 30.00% |  |
Maximum |  |  |  |  |  |  |  |  |  |
Noncontrolling Interest [Line Items] |  |  |  |  |  |  |  |  |  |
Current economic interest in the APAC JV, Owned by the Parent Company |  |  | 50.00% |  |  |  |  | 50.00% |  |
Ownership percentage by Parent |  |  | 50.00% |  |  |  |  | 50.00% |  |
Subsequent Event |  |  |  |  |  |  |  |  |  |
Noncontrolling Interest [Line Items] |  |  |  |  |  |  |  |  |  |
Equity Method Investment, Additional Information |  | Subsequent to December 31, 2018, the investors have jointly agreed to a further deferral of those capital contributions originally scheduled for August 1, 2018, which will now be due with the final capital contributions |  |  |  |  |  |  |  |
Asia-Pacific dialysis business | Khazanah And Mitsui |  |  |  |  |  |  |  |  |  |
Noncontrolling Interest [Line Items] |  |  |  |  |  |  |  |  |  |
Non-cash non-taxable gain | $ (374,374) |  |  |  |  |  | $ (6,273) |  |  |

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