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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Amount of liabilities incurred by the acquirer as part of consideration transferred in a business combination.

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Fair value at acquisition-date of the equity interest in the acquiree held by the acquirer, immediately before the acquisition date for businesses combined in stages.

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Acquisitions and divestitures (Details) $ in Thousands	3 Months Ended		6 Months Ended
Acquisitions and divestitures (Details) $ in Thousands	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($) Clinic	Jun. 30, 2023 USD ($)
Business Acquisition [Line Items]
Cash paid to acquire businesses			$ 157,783	$ 2,575
Gain on changes in ownership interest	$ 0	$ 0	35,147	$ 0
Dialysis and other businesses
Business Acquisition [Line Items]
Cash paid to acquire businesses			157,783
Deferred purchase price obligations			51,768
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			12
Dialysis and other businesses \| Foreign Dialysis Centers
Business Acquisition [Line Items]
Number of businesses acquired \| Clinic			90