Goodwill Goodwill - Schedule of Reporting Units Goodwill Balances (Details) (Details) - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Goodwill [Line Items]
Goodwill	$ 6,799,368	$ 6,841,960	$ 6,610,279
Percentage Change In Operating Income Used To Evaluate Fair Value Of Reporting Unit For Goodwill Assessment	3.00%
Percentage Change In Discount Rate Used To Evaluate Fair Value Of Reporting Unit For Goodwill Assessment	1.00%
GERMANY \| Kidney Care
Goodwill [Line Items]
Goodwill	$ 354,182
Reporting Unit Percentage Of Fair Value In Excess Of Short Of Carrying Amount	0.00%
Potential Impact On Fair Value For Reduction In Operating Income	(1.40%)
Potential Impact On Fair Value For Basis Point Increase In Discount Rate	(9.30%)

Percentage change in discount rate used to evaluate fair value of reporting unit for goodwill assessment.

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- Definition

Percentage change in operating income used to evaluate fair value of reporting unit for goodwill assessment.

+ References

No definition available.

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- Definition

Potential Impact On Fair Value For Basis Point Increase In Discount Rate

+ References

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- Definition

Potential Impact On Fair Value For Reduction In Operating Income

+ References

No definition available.

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- Definition

Reporting unit percentage of fair value in excess of short of carrying amount.

+ References

No definition available.

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- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 20
-Section 45
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=77989000&loc=SL49117168-202975

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 20
-Section 45
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=99380562&loc=d3e13770-109266

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- Definition

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.

+ References

No definition available.

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