Segment reporting - Summary of Depreciation and Amortization Expense by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2025	Mar. 31, 2024
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 176,451	$ 187,083
U S Dialysis And Related Lab Services [Member]
Segment Reporting Information [Line Items]
Depreciation and amortization	156,899	172,852
Other Operating Segment [Member]
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 19,552	$ 14,231

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