Foreign travel for dialysis patients
Holidays require considerable forward planning, especially if requested at units close to popular holiday destinations. Requests should be in writing, a minimum of 6 weeks include relevant patient and dialysis provision details and, if possible, propose alternative dates. Only dialysis centres judged unlikely to infect patients with HepB/HIV/HepC are acceptable. Dialysis requests to foreign centres should, therefore, explicitly request confirmation that the unit conducts virus surveillance and segregates infected patients. When the risk of infection exists, or is uncertain, patients must be made aware of risk and upon return to Edinburgh unit treated as BBV positive (segregated) and suspended on transplant list for six months. There is also increasing awareness of the potential risks of transmission of antibiotic resistant bacteria through holiday dialysis. As a consequence many centres may request swabs (examples MRSA, CPE/CRE) before and/or after visiting a holiday dialysis centre. Current guidelines and info on holiday dialysis can be downloaded at the foot of the page.
Dialysis at destinations in the developed world can usually be organised by our Holiday Dialysis Coordinator, provided a holiday address is available for delivery and storage of PD fluid. This is arranged by the relevant company – Baxters or Fresenius. They will write confirming the PF fluids etc. Supplied with the delivery address and details of the nearest PD unit.
Patients should carry a letter for Customs.
Patients with renal failure make relatively poor antibody responses to immunisation but should still be offered immunisations as recommended for the geographical area of travel, with one or two particular exceptions.
Immunosuppressed patients should not receive live virus vaccines – these include yellow fever, conventional oral (Sabin) polio vaccine, and oral typhoid vaccine. If polio cover is required obtain the killed (Salk) polio vaccine.
Hepatitis B: All haemodialysis patients should have been immunised. Check current immune status and discuss with Department of Virology. If negative and travelling to a high risk area, immunoglobulin may be required.
Malaria prophylaxis is difficult because Proguanil is contra-indicated (potential marrow toxicity). No ideal regime is available. Up to date information should be sought from renal pharmacist or medicines information.
Dialysis patients travelling abroad must buy adequate health insurance, particularly if travelling to the USA. The National Kidney Federation website www.kidney.org.uk is one possible source of information about suitable insurance companies.
In Europe, dialysis patients must carry a European Health Card (EHIC)
Acknowledgements: Caroline Whitworth was the main author for this page. The last modified date is shown in the footer.