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Goodwill (Tables)
 6 Months Ended
Jun. 30, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Changes in Goodwill by Reportable Segments [Text Block]
Changes in the carrying value of goodwill by reportable segment were as follows:
U.S. dialysisOther — Ancillary servicesConsolidated
Balance at December 31, 2023$6,416,825 $695,735 $7,112,560 
Acquisitions102,082 246,987 349,069 
Divestitures(1,687)(1,506)(3,193)
Foreign currency and other adjustments— (83,220)(83,220)
Balance at December 31, 20246,517,220 857,996 7,375,216 
Acquisitions5,384 (4,715)669 
Foreign currency and other adjustments— 89,884 89,884 
Balance at June 30, 2025$6,522,604 $943,165 $7,465,769 
Balance at June 30, 2025:
Goodwill$6,522,604 $1,099,747 $7,622,351 
Accumulated impairment charges— (156,582)(156,582)
$6,522,604 $943,165 $7,465,769