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Segment reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes (Detail) - USD ($)
$ in Thousands
 3 Months Ended 6 Months Ended
Jun. 30, 2022
Jun. 30, 2021
Jun. 30, 2022
Jun. 30, 2021
Segment Reporting Information [Line Items]        
Other revenues $ 116,658 $ 98,553 $ 217,932 $ 203,967
Total revenues 2,926,757 2,916,510 5,744,312 5,736,511
Operating income (loss) 432,715 490,476 771,023 933,078
Corporate administrative support (30,973) (25,495) (66,800) (50,940)
Debt expense (82,586) (73,324) (156,377) (140,338)
Other (loss) income, net (1,284) 15,188 (3,070) 16,356
Income before income taxes 348,845 432,340 611,576 809,096
U.S. dialysis        
Segment Reporting Information [Line Items]        
Total revenues 2,643,851 2,655,021 5,196,778 5,217,897
Other—Ancillary services        
Segment Reporting Information [Line Items]        
Total revenues 282,906 261,489 547,534 518,614
Operating Segments        
Segment Reporting Information [Line Items]        
Total revenues 2,946,146 2,937,827 5,785,870 5,789,125
Operating income (loss) 463,688 515,971 837,823 984,018
Operating Segments | U.S. dialysis        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 2,657,148 2,669,923 5,226,268 5,253,126
Total revenues 2,663,240 2,676,338 5,238,336 5,266,217
Operating income (loss) 472,801 533,779 879,241 1,013,686
Operating Segments | U.S. dialysis | External Sources        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 2,637,738 2,648,676 5,184,700 5,204,936
Other revenues 6,113 6,345 12,078 12,961
Operating Segments | U.S. dialysis | Intersubsegment Eliminations        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 19,410 21,247 41,568 48,190
Other revenues (21) 70 (10) 130
Operating Segments | Other—Ancillary services        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 172,361 169,281 341,680 327,608
Other revenues 110,545 92,208 205,854 191,006
Total revenues 282,906 261,489 547,534 522,908
Operating income (loss) (9,113) (17,808) (41,418) (29,668)
Operating Segments | Other—Ancillary services | Intersubsegment Eliminations        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 0 0 0 4,294
Intersegment Elimination        
Segment Reporting Information [Line Items]        
Total revenues (19,389) (21,317) (41,558) (52,614)
Intersegment Elimination | U.S. dialysis        
Segment Reporting Information [Line Items]        
Total revenues (19,389) (21,317) (41,558) (48,320)
Intersegment Elimination | Other—Ancillary services        
Segment Reporting Information [Line Items]        
Total revenues $ 0 $ (4,294)