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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, 2023
Jun. 30, 2022
Jun. 30, 2023
Jun. 30, 2022
Segment Reporting Information [Line Items]        
Other revenues $ 109,684 $ 116,658 $ 222,349 $ 217,932
Total revenues 3,000,369 2,926,757 5,873,068 5,744,312
Operating income (loss) 405,291 432,715 716,936 771,023
Corporate administrative support (33,864) (30,973) (58,452) (66,800)
Debt expense (103,507) (82,586) (204,281) (156,377)
Debt prepayment and refinancing charges (7,962) 0 (7,962) 0
Other income (loss), net 1,373 (1,284) 5,125 (3,070)
Income before income taxes 295,195 348,845 509,818 611,576
U.S. dialysis        
Segment Reporting Information [Line Items]        
Total revenues 2,710,254 2,643,851 5,300,365 5,196,778
Other—Ancillary services        
Segment Reporting Information [Line Items]        
Total revenues 290,115 282,906 572,703 547,534
Operating Segments        
Segment Reporting Information [Line Items]        
Total revenues 3,022,138 2,946,146 5,918,252 5,785,870
Operating income (loss) 439,155 463,688 775,388 837,823
Operating Segments | U.S. dialysis        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 2,724,211 2,657,148 5,330,192 5,226,268
Total revenues 2,730,615 2,663,240 5,342,775 5,238,336
Operating income (loss) 460,759 472,801 821,857 879,241
Operating Segments | U.S. dialysis | External Sources        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 2,703,850 2,637,738 5,287,782 5,184,700
Other revenues 6,404 6,113 12,583 12,078
Operating Segments | U.S. dialysis | Intersubsegment Eliminations        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 20,361 19,410 42,410 41,568
Other revenues 0 (21) 0 (10)
Operating Segments | Other—Ancillary services        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 186,835 172,361 362,937 341,680
Other revenues 103,280 110,545 209,766 205,854
Total revenues 291,523 282,906 575,477 547,534
Operating income (loss) (21,604) (9,113) (46,469) (41,418)
Operating Segments | Other—Ancillary services | Intersubsegment Eliminations        
Segment Reporting Information [Line Items]        
Dialysis patient service revenues 1,408 0 2,774 0
Intersegment Elimination        
Segment Reporting Information [Line Items]        
Total revenues (21,769) (19,389) (45,184) (41,558)
Intersegment Elimination | U.S. dialysis        
Segment Reporting Information [Line Items]        
Total revenues (20,361) $ (19,389) (42,410) $ (41,558)
Intersegment Elimination | Other—Ancillary services        
Segment Reporting Information [Line Items]        
Total revenues $ (1,408)   $ (2,774)