Acquisitions and divestitures (Details) $ in Thousands	3 Months Ended
Mar. 31, 2024 USD ($) Clinic	Mar. 31, 2023 USD ($)
Business Acquisition [Line Items]
Payments to Acquire Businesses, Gross	$ 105,163	$ 0
Gain on changes in ownership interest	35,147	$ 0
Dialysis and other businesses
Business Acquisition [Line Items]
Payments to Acquire Businesses, Gross	105,163
Deferred purchase price obligations	357
Business Combination, Step Acquisition, Equity Interest in Acquiree, Fair Value	67,526
Gain on changes in ownership interest	$ 35,147
Dialysis and other businesses \| U.S. dialysis
Business Acquisition [Line Items]
Number of businesses acquired \| Clinic	9
Dialysis and other businesses \| Foreign Dialysis Centers
Business Acquisition [Line Items]
Number of businesses acquired \| Clinic	67

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.

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