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Segment reporting - Summary of Assets by Segment (Detail) - USD ($) $ in Thousands | Jun. 30, 2019 | Dec. 31, 2018
--- | --- | ---
ASSETS |  |
Total assets | $ 19,930,960 | $ 19,110,252
U.S. dialysis and related lab services |  |
ASSETS |  |
Total assets | 18,352,683 | 12,333,641
Other—Ancillary services and strategic initiatives |  |
ASSETS |  |
Total assets | 1,578,277 | 1,387,046
DMG held for sale |  |
ASSETS |  |
Total assets | $ 0 | $ 5,389,565

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