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Acquisitions and divestitures Contingent Earn-out obligations (Details) - Dialysis and other businesses - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended
--- | --- | ---
Jun. 30, 2022 | Jun. 30, 2022
Business Acquisition [Line Items] |  |
Contingent Earn-out Obligations, Beginning balance | $ 34,193 | $ 33,600
Acquisitions | 278 | 523
Foreign currency translation | (2,104) | 1,144
Fair value remeasurements | (2,799) | (2,779)
Payments | (269) | (3,189)
Contingent Earn-out Obligations, Ending balance | $ 29,299 | $ 29,299

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