Summary of Expenditures for Property and Equipment by Segment (Detail) - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2017	Mar. 31, 2016
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 214,535	$ 173,187
U.S. dialysis and related lab services
Segment Reporting Information [Line Items]
Expenditures for property and equipment	173,528	133,450
DMG
Segment Reporting Information [Line Items]
Expenditures for property and equipment	27,788	20,145
Ancillary services and strategic initiatives
Segment Reporting Information [Line Items]
Expenditures for property and equipment	$ 13,219	$ 19,592

The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets.

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Glossary Investing Activities
-URI http://asc.fasb.org/extlink&oid=6516133

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 13
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=66902209&loc=d3e3213-108585

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Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration