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Acquisitions and divestitures (Details) $ in Thousands | 3 Months Ended
--- | ---
Mar. 31, 2024 USD ($) Clinic | Mar. 31, 2023 USD ($)
Business Acquisition [Line Items] |  |
Payments to Acquire Businesses, Gross | $ 105,163 | $ 0
Gain on changes in ownership interest | 35,147 | $ 0
Dialysis and other businesses |  |
Business Acquisition [Line Items] |  |
Payments to Acquire Businesses, Gross | 105,163 |
Deferred purchase price obligations | 357 |
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value | 67,526 |
Gain on changes in ownership interest | $ 35,147 |
Dialysis and other businesses | U.S. dialysis |  |
Business Acquisition [Line Items] |  |
Number of businesses acquired | Clinic | 9 |
Dialysis and other businesses | Foreign Dialysis Centers |  |
Business Acquisition [Line Items] |  |
Number of businesses acquired | Clinic | 67 |

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