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Acquisitions and divestitures Contingent Earn-out obligations (Details) - Dialysis and other businesses - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2022
Business Acquisition [Line Items]
Contingent Earn-out Obligations, Beginning balance	$ 29,299	$ 33,600
Acquisitions	1,648	2,171
Foreign currency translation	(741)	403
Fair value remeasurements	(350)	(3,129)
Payments	(4,085)	(7,274)
Contingent Earn-out Obligations, Ending balance	$ 25,771	$ 25,771

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- Definition

Business Combination Contingent Consideration Acquisitions Fair Value Remeasurement Gain Loss

+ References

No definition available.

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- Definition

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+ References

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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.

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- Definition

Amount of increase (decrease) in the value of right to a contingent consideration asset.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 28
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126954810&loc=d3e3602-108585

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
-Section 50
-Paragraph 4
-Subparagraph (a)(1)
-URI https://asc.fasb.org/extlink&oid=126975305&loc=d3e7008-128479

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- Definition

Amount of increase (decrease) in the value of a contingent consideration liability, including, but not limited to, differences arising upon settlement.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 28
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126954810&loc=d3e3602-108585

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
-Section 50
-Paragraph 4
-Subparagraph (a)(1)
-URI https://asc.fasb.org/extlink&oid=126975305&loc=d3e7008-128479

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- Definition

For contingent consideration arrangements recognized in connection with a business combination, this element represents an estimate of the high-end of the potential range (undiscounted) of the consideration which may be paid.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 30
-Section 50
-Paragraph 1
-Subparagraph (c)(3)
-URI https://asc.fasb.org/extlink&oid=126975305&loc=d3e6927-128479

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