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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, 2024
Jun. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Segment Reporting Information [Line Items]          
Other revenues $ 125,029   $ 169,382 $ 379,672 $ 391,731
Total revenues 3,263,590   3,121,332 9,520,867 8,994,400
Operating income (loss) 534,878   495,939 1,525,121 1,212,875
Corporate administrative support (28,504)   (41,294) (84,090) (99,745)
Debt expense (134,583)   (98,080) (331,748) (302,361)
Debt prepayment, extinguishment and modification costs (10,081) $ (9,732) 0 (19,813) (7,962)
Other loss, net (16,780)   (19,650) (56,900) (14,525)
Income before income taxes 373,434   378,209 1,116,660 888,027
U.S. dialysis          
Segment Reporting Information [Line Items]          
Total revenues 2,889,860   2,761,017 8,449,642 8,061,383
Other—Ancillary services          
Segment Reporting Information [Line Items]          
Total revenues 373,730   360,315 1,071,225 933,017
Operating Segments          
Segment Reporting Information [Line Items]          
Total revenues 3,282,328   3,147,853 9,583,563 9,066,105
Operating income (loss) 563,382   537,233 1,609,211 1,312,620
Operating Segments | U.S. dialysis          
Segment Reporting Information [Line Items]          
Dialysis patient service revenues 2,899,796   2,779,067 8,484,946 8,109,259
Total revenues 2,906,000   2,785,306 8,503,170 8,128,081
Operating income (loss) 549,476   509,135 1,625,399 1,330,992
Operating Segments | U.S. dialysis | External Sources          
Segment Reporting Information [Line Items]          
Dialysis patient service revenues 2,883,656   2,754,778 8,431,418 8,042,561
Other revenues 6,204   6,239 18,224 18,822
Operating Segments | U.S. dialysis | Intersubsegment Eliminations          
Segment Reporting Information [Line Items]          
Dialysis patient service revenues 16,140   24,289 53,528 66,698
Operating Segments | Other—Ancillary services          
Segment Reporting Information [Line Items]          
Dialysis patient service revenues 254,905   197,172 709,777 560,108
Other revenues 118,825   163,143 361,448 372,909
Total revenues 376,328   362,547 1,080,393 938,024
Operating income (loss) 13,906   28,098 (16,188) (18,372)
Operating Segments | Other—Ancillary services | Intersubsegment Eliminations          
Segment Reporting Information [Line Items]          
Dialysis patient service revenues 2,598   2,232 9,168 5,007
Intersegment Elimination          
Segment Reporting Information [Line Items]          
Total revenues (18,738)   (26,521) (62,696) (71,705)
Intersegment Elimination | U.S. dialysis          
Segment Reporting Information [Line Items]          
Total revenues (16,140)   (24,289) (53,528) (66,698)
Intersegment Elimination | Other—Ancillary services          
Segment Reporting Information [Line Items]          
Total revenues $ (2,598)   $ (2,232) $ (9,168) $ (5,007)