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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 9 Months Ended
Sep. 30, 2022
Sep. 30, 2021
Sep. 30, 2022
Sep. 30, 2021
Segment Reporting Information [Line Items]        
Other revenues $ 102,200 $ 100,379 $ 320,132 $ 304,346
Total revenues 2,948,694 2,938,319 8,693,006 8,674,830
Operating income (loss) 311,787 474,877 1,082,810 1,407,955
Corporate administrative support (24,417) (28,153) (91,217) (79,093)
Debt expense (99,680) (72,829) (256,057) (213,167)
Other (loss) income, net (4,898) (7,590) (7,968) 8,766
Income before income taxes 207,209 394,458 818,785 1,203,554
U.S. dialysis        
Segment Reporting Information [Line Items]        
Total revenues 2,680,296 2,675,942 7,877,073 7,893,839
Other—Ancillary services        
Segment Reporting Information [Line Items]        
Total revenues 268,398 262,377 815,933 780,991
Operating Segments        
Segment Reporting Information [Line Items]        
Total revenues 2,971,651 2,960,423 8,757,522 8,749,548
Operating income (loss) 336,203 503,030 1,174,026 1,487,048
Operating Segments | U.S. dialysis        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 2,697,197 2,691,830 7,923,465 7,944,955
Total revenues 2,703,253 2,698,046 7,941,589 7,964,263
Operating income (loss) 351,474 509,939 1,230,715 1,523,625
Operating Segments | U.S. dialysis | External Sources        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 2,674,240 2,669,823 7,858,939 7,874,759
Other revenues 6,056 6,119 18,134 19,080
Operating Segments | U.S. dialysis | Intersubsegment Eliminations        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 22,957 22,007 64,526 70,196
Other revenues 0 97 (10) 228
Operating Segments | Other—Ancillary services        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 172,254 168,117 513,935 495,725
Other revenues 96,144 94,260 301,998 285,266
Total revenues 268,398 262,377 815,933 785,285
Operating income (loss) (15,271) (6,909) (56,689) (36,577)
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 (22,957) (22,104) (64,516) (74,718)
Intersegment Elimination | U.S. dialysis        
Segment Reporting Information [Line Items]        
Total revenues (22,957) (22,104) (64,516) (70,424)
Intersegment Elimination | Other—Ancillary services        
Segment Reporting Information [Line Items]        
Total revenues $ (4,294)