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Segment reporting - Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands | 9 Months Ended
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Sep. 30, 2021 | Sep. 30, 2020
Segment Reporting Information [Line Items] |  |
Expenditures for property and equipment | $ 451,909 | $ 449,896
U.S. dialysis |  |
Segment Reporting Information [Line Items] |  |
Expenditures for property and equipment | 415,994 | 430,646
Other—Ancillary services |  |
Segment Reporting Information [Line Items] |  |
Expenditures for property and equipment | $ 35,915 | $ 19,250

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- 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=123570139&loc=d3e3213-108585 + Details
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Balance Type: | credit
Period Type: | duration

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- 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. + Details
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Period Type: | duration

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- Details
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Namespace Prefix: |
Data Type: | na
Balance Type: |
Period Type: |

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- Details
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