v3.26.1
Segment reporting - Summary of Segment Net Revenues, Segment Operating Income (Loss) and Reconciliation of Segment Income to Consolidated Income Before Income Taxes (Detail) - USD ($)
$ in Thousands
 3 Months Ended 6 Months Ended
Jun. 30, 2026
Jun. 30, 2025
Jun. 30, 2026
Jun. 30, 2025
Segment Reporting [Line Items]        
Other revenues $ 187,707 $ 172,655 $ 330,458 $ 293,191
Total revenues 3,554,084 3,379,526 6,969,632 6,603,055
Operating income (loss) 579,001 537,841 1,060,893 976,778
Corporate administrative support (16,025) (41,717) (45,933) (75,745)
Debt expense (150,256) (146,062) (295,387) (281,117)
Debt extinguishment and modification costs (2,035) 0 (2,035) 0
Other income (loss), net 8,300 (22,851) 12,773 (40,400)
Income before income taxes 435,010 368,928 776,244 655,261
Patient care costs 2,392,001 2,261,540 4,734,258 4,501,200
General and administrative 423,458 412,805 845,372 786,895
Depreciation and amortization 167,808 174,704 345,637 351,155
Operating expenses 2,975,083 2,841,685 5,908,739 5,626,277
U. S. Dialysis And Related Lab Services        
Segment Reporting [Line Items]        
Total revenues 3,000,462 2,896,675 5,921,692 5,708,110
Depreciation and amortization 146,461 156,782 301,631 313,681
Other Operating Segment        
Segment Reporting [Line Items]        
Total revenues 553,622 482,851 1,047,940 894,945
Depreciation and amortization 21,347 17,923 44,006 37,474
Operating Segments        
Segment Reporting [Line Items]        
Total revenues 3,568,532 3,399,078 7,007,840 6,637,070
Operating income (loss) 595,026 579,558 1,106,826 1,052,523
Operating Segments | U. S. Dialysis And Related Lab Services        
Segment Reporting [Line Items]        
Operating income (loss) 537,976 522,844 1,043,944 998,617
Patient care costs 2,004,694 1,928,462 3,973,750 3,841,890
General and administrative 330,892 312,089 650,664 594,768
Segment Reporting, Other Segment Item, Amount (8,200) (6,786) (16,464) (12,396)
Operating expenses 2,473,847 2,390,547 4,909,581 4,737,943
Operating Segments | Other Operating Segment        
Segment Reporting [Line Items]        
Operating income (loss) 57,050 56,714 62,882 53,906
Operating Segments | U S Dialysis And Related Lab Services with Intersegment        
Segment Reporting [Line Items]        
Dialysis patient service revenues 3,005,309 2,907,425 5,940,735 5,724,586
Total revenues 3,011,823 2,913,391 5,953,525 5,736,560
Operating Segments | U S Dialysis And Related Lab Services with Intersegment | External Sources        
Segment Reporting [Line Items]        
Dialysis patient service revenues 2,993,948 2,890,709 5,908,902 5,696,136
Other revenues 6,514 5,966 12,790 11,974
Operating Segments | U S Dialysis And Related Lab Services with Intersegment | Intersubsegment Eliminations        
Segment Reporting [Line Items]        
Dialysis patient service revenues 11,361 16,716 31,833 28,450
Operating Segments | Other Operating Segments with Intersegment        
Segment Reporting [Line Items]        
Dialysis patient service revenues 372,429 316,162 730,272 613,728
Other revenues 181,193 166,689 317,668 281,217
Total revenues 556,709 485,687 1,054,315 900,510
Operating Segments | Other Operating Segments with Intersegment | Intersubsegment Eliminations        
Segment Reporting [Line Items]        
Other revenues 3,087 2,836 6,375 5,565
Intersegment Elimination        
Segment Reporting [Line Items]        
Total revenues (14,448) (19,552) (38,208) (34,015)
Intersegment Elimination | U. S. Dialysis And Related Lab Services        
Segment Reporting [Line Items]        
Total revenues (11,361) (16,716) (31,833) (28,450)
Intersegment Elimination | Other Operating Segment        
Segment Reporting [Line Items]        
Total revenues $ (3,087) $ (2,836) $ (6,375) $ (5,565)