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Segment reporting (Tables)
 6 Months Ended
Jun. 30, 2023
Segment Reporting [Abstract]  
Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes
The following is a summary of segment revenues, segment operating margin (loss), and a reconciliation of segment operating margin to consolidated income before income taxes:
Three months ended June 30,Six months ended June 30,
 2023202220232022
Segment revenues:  
U.S. dialysis  
Dialysis patient service revenues:  
External sources$2,703,850 $2,637,738 $5,287,782 $5,184,700 
Intersegment revenues20,361 19,410 42,410 41,568 
U.S. dialysis patient service revenues2,724,211 2,657,148 5,330,192 5,226,268 
Other revenues:
External sources6,404 6,113 12,583 12,078 
Intersegment revenues— (21)— (10)
Total U.S. dialysis revenues2,730,615 2,663,240 5,342,775 5,238,336 
Other—Ancillary services
Dialysis patient service revenues186,835 172,361 362,937 341,680 
Other external sources103,280 110,545 209,766 205,854 
Intersegment revenues1,408 — 2,774 — 
Total ancillary services revenues291,523 282,906 575,477 547,534 
Total net segment revenues3,022,138 2,946,146 5,918,252 5,785,870 
Elimination of intersegment revenues(21,769)(19,389)(45,184)(41,558)
Consolidated revenues$3,000,369 $2,926,757 $5,873,068 $5,744,312 
Segment operating margin (loss):  
U.S. dialysis$460,759 $472,801 $821,857 $879,241 
Other—Ancillary services(21,604)(9,113)(46,469)(41,418)
Total segment operating margin439,155 463,688 775,388 837,823 
Reconciliation of segment operating income to
 consolidated income before income taxes:		  
Corporate administrative support(33,864)(30,973)(58,452)(66,800)
Consolidated operating income405,291 432,715 716,936 771,023 
Debt expense(103,507)(82,586)(204,281)(156,377)
Debt prepayment and refinancing charges(7,962)— (7,962)— 
Other income (loss), net1,373 (1,284)5,125 (3,070)
Consolidated income before income taxes$295,195 $348,845 $509,818 $611,576 
Summary of Depreciation and Amortization Expense by Reportable Segment
Depreciation and amortization expense by reportable segment was as follows:
Three months ended June 30,Six months ended June 30,
 2023202220232022
U.S. dialysis$171,842 $160,612 $338,803 $322,632 
Other—Ancillary services11,830 10,564 22,940 21,488 
 $183,672 $171,176 $361,743 $344,120 
Summary of Expenditures for Property and Equipment by Reportable Segment Expenditures for property and equipment by reportable segment were as follows:
Six months ended June 30,
 20232022
U.S. dialysis$240,474 $237,686 
Other—Ancillary services31,730 27,775 
 $272,204 $265,461 
Summary of Assets by Reportable Segment
A summary of assets by reportable segment were as follows:
June 30, 2023December 31, 2022
U.S. dialysis$14,592,384 $15,084,454 
Other—Ancillary services2,366,461 1,843,798 
Consolidated assets$16,958,845 $16,928,252