Top Tips for Travelling with Kidney Disease

What is CKD?

More than 7.2 million people in the UK have been diagnosed with chronic kidney disease (CKD) – that’s more than 1 in 10 adults.  

Having CKD means your kidneys aren’t working as efficiently as they should. CKD is divided into 5 stages, depending on how fast your kidney filters fluid from your system – your eGFR – and how much protein leaks through to your urine. Most people have mild (stage 1-2) or moderate (stage 3) CKD.

Stage 5 CKD is sometimes called end-stage kidney disease. At this stage, your kidneys are severely damaged and working at less than 15% of their normal capacity. If you have stage 5 CKD, you’re likely to be having regular dialysis or waiting to start it. You’re also likely to have significant restrictions on your diet and lifestyle.

If you have stage 1 or 2 CKD, your kidneys are filtering normally so your eGFR will be above 60. However, your kidneys are more leaky than they should be, and allow a protein called albumin to leak out into your urine.

If you have stages 1-3 CKD, the chances are that you’ll have no symptoms at all. But even if you feel well, your kidneys are more vulnerable to further damage if you get dehydrated. So there are certain steps you can take to ensure you have a trouble-free holiday.

Regardless of what stage your CKD is, you’ll need regular monitoring and will need to take daily medication. You’ll also be having regular blood pressure checks. All this should be provided by your GP practice unless you have stage 4 or 5 CKD, in which case you’ll be under regular follow-up from a specialist team.

Top Tips for Travelling with CKD

• If you have mild or moderate CKD, you’re unlikely to have any specific problems with travelling. It is important to avoid dehydration, as this can damage your kidneys. So do keep your fluid intake up, especially if you’re travelling to hot countries.
  
  
• Many people with mild or moderate CKD are treated with medicines called ACE inhibitors (they have names ending ‘-pril’) or ARBs (with names ending ‘-sartan’). These can help control your blood pressure and protect your kidneys, so it’s important to take them regularly. However, if you become acutely unwell with diarrhoea and/or vomiting, you should seek medical help and stop taking them in the meantime.
  
  
• You may also be taking medicines called ‘flozins’ or SGLT2-inhibitors. These medicines were originally designed for people with type 2 diabetes to keep blood sugar under control. They have since been found to offer significant kidney protection for people with CKD. You may therefore be prescribed dapagliflozin or empagliflozin regardless of whether you have type 2 diabetes. If you do have type 2 diabetes as well, it’s important to pause this medicine if you have diarrhoea and vomiting, or are dehydrated for any other reason.
  
  
• If you’re taking tablets, make sure you have enough to last for your whole holiday and for a few days extra, in case of delays. Order them from your GP well in advance.
  
  
• Whatever stage of CKD you have, it’s worth checking with your GP before you go whether you need blood tests and a check-up prior to booking or departure.
  
  
• Carry your medication in your hand luggage and ideally, put some in your hold luggage or the hand luggage of someone you’re travelling with. This way, you’ll still have a supply if one of your bags goes astray.
  
  
• If you’re taking liquid medicine, you can take it in your hand luggage even if it’s more than 100ml. However, you’ll need a letter from your GP confirming the details of all your medications and you should check with your airline first.
  
  
• Take your medicines in their original packaging, with a copy of your repeat prescription. If you have severe CKD and are taking several medicines, read our article on travelling with medication for more advice.
  
  
• If you’re on a special diet, it’s essential to stick to it while you’re away. Research your destination and contact the place you’re staying to check if they can accommodate your needs.

Top Tips for Travelling on Dialysis

• If you’re having regular dialysis, arrange to travel on a day you don’t need treatment – you should never miss a treatment.
  
  
• If you need dialysis while you’re away, you should be able to arrange this through your local dialysis unit. However, you’ll need to give them as much notice as you can (ideally at least 3 months) so they can arrange this with a unit in the country you’re visiting.
  
  
• If you have a valid European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC), you’ll be able to use it to access dialysis while you’re away if you’re in a country the card covers. This may be free, but you may need to pay up to 20% of the cost of dialysis yourself as a non-refundable ‘co-payment’.
  
  
• The NHS will not cover the cost of any dialysis outside countries covered by the EHIC or GHIC unless that country has a reciprocal agreement with the UK. Even if it does, you’ll need to check with local state providers that they do offer this.
  
  
• When you come back, you may need to take special precautions (including being dialysed in isolation for 10 days) because of the risk of infectious diseases, including COVID-19. Once you’ve been tested for infectious diseases and your results are clear, you can go back to your previous regime.
  
  
• If you’re on peritoneal dialysis, your unit or fluid supply company can arrange for your dialysis fluid to be delivered to where you’re staying. However, you’ll need to contact the place you’re staying to check they’re happy to receive clinical supplies.
  
  
• If you’re using a portable home haemodialysis machine, your dialysis team can help you with the logistics of transporting your machine and getting supplies while you’re away. Don’t forget to pack an adaptor for the machine.
  
  You can find more details on how to have a relaxing and trouble-free holiday if you’re on dialysis from our blog on dialysis on holiday.