Goodwill - Changes in Goodwill by Reportable Segments (Detail) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended	12 Months Ended
Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Goodwill [Roll Forward]
Beginning balance			$ 6,841,960	$ 6,610,279	$ 6,610,279
Acquisitions			66,614		278,348
Divestitures					(15,497)
Impairment charges	$ 0	$ (3,106)	(41,037)	(3,106)	(3,106)
Foreign currency and other adjustments			(2,151)		(28,064)
Ending balance	6,865,386		6,865,386		6,841,960
Goodwill	6,933,984		6,933,984
Accumulated impairment charges	(68,598)		(68,598)
Ending balance	6,865,386		6,865,386		6,841,960
U.S. dialysis and related lab services
Goodwill [Roll Forward]
Beginning balance			6,275,004	6,144,761	6,144,761
Acquisitions			15,714		130,574
Divestitures					(331)
Impairment charges			0		0
Foreign currency and other adjustments			0		0
Ending balance	6,290,718		6,290,718		6,275,004
Goodwill	6,290,718		6,290,718
Accumulated impairment charges	0		0
Ending balance	6,290,718		6,290,718		6,275,004
Other—Ancillary services and strategic initiatives
Goodwill [Roll Forward]
Beginning balance			566,956	$ 465,518	465,518
Acquisitions			50,900		147,774
Divestitures					(15,166)
Impairment charges			(41,037)		(3,106)
Foreign currency and other adjustments			(2,151)		(28,064)
Ending balance	574,668		574,668		566,956
Goodwill	643,266		643,266
Accumulated impairment charges	(68,598)		(68,598)
Ending balance	$ 574,668		$ 574,668		$ 566,956

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.

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Amount of increase in asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized resulting from a business combination.

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Amount of foreign currency translation gain (loss) which increases (decreases) an asset representing future economic benefits from other assets acquired in a business combination that are not individually identified and separately recognized.

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Amount before 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.

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

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Amount of loss from the write-down of an asset representing the future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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A roll forward is a reconciliation of a concept from the beginning of a period to the end of a period.

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

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