Segment reporting - Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
Jun. 30, 2025	Jun. 30, 2024	Jun. 30, 2025	Jun. 30, 2024
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 174,704	$ 175,661	$ 351,155	$ 362,744
U. S. Dialysis And Related Lab Services
Segment Reporting Information [Line Items]
Depreciation and amortization	156,782	160,410	313,681	333,262
Other Operating Segment
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 17,923	$ 15,251	$ 37,474	$ 29,482

The current period expense charged against earnings on long-lived, physical assets not used in production, and which are not intended for resale, to allocate or recognize the cost of such assets over their useful lives; or to record the reduction in book value of an intangible asset over the benefit period of such asset; or to reflect consumption during the period of an asset that is not used in production.

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section 45
-Paragraph 28
-Subparagraph (b)
-SubTopic 10
-Topic 230
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482740/230-10-45-28

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482099/360-10-50-1

Name:	us-gaap_DepreciationAndAmortization
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	duration