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Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($)
$ in Thousands
6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Segment Reporting Information [Line Items]    
Expenditures for property and equipment $ 291,667 $ 373,918
U.S. dialysis    
Segment Reporting Information [Line Items]    
Expenditures for property and equipment 280,801 319,812
Other—Ancillary services    
Segment Reporting Information [Line Items]    
Expenditures for property and equipment 10,866 15,640
DMG - Discontinued operations    
Segment Reporting Information [Line Items]    
Expenditures for property and equipment $ 0 $ 38,466