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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
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 173,265	$ 231,682	$ 547,183	$ 705,659
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	157,721	214,728	477,533	603,186
Other—Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Expenditures for property and equipment	15,544	5,019	31,184	37,191
DMG held for sale
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 0	$ 11,935	$ 38,466	$ 65,282

X

- 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=118932676&loc=d3e3213-108585

+ Details

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X

- 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.

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- Details

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