Best Option For Traveling

I am on clinic dialysis at the moment and am interested in moving to home dialysis and just beginning my research. I am leaning toward HD vs PD and would like opinions about being able to travel. I don’t expect to be a frequent traveler but do need to take occasional business trips that may last a few days. What is the best option? Is going to a clinic while on the road the best solution?

In fact, I am on three a week dialysis in the clinic and have a situation now where I need to make a Monday trip and am not able to find a clinic for a Monday treatment at my destination. I plan on skipping dialysis on that day and returning back to my home base clinic for a Tuesday treatment and then Wednesday and Friday for my three days.

Thanks.

In-center dialysis is the hardest treatment option to travel with. As you probably found out, you have to plan ahead. Spontaneous trips are almost impossible unless it’s for an emergency. A lot of paperwork needs to be done and sent. Most clinics require 30-60 days’ notice and some are always full. Many times businesses expect their employees to travel with shorter notice than that. However, sometimes businesses are finding that work can often be done cheaper and with greater efficiency by teleconference or webinar. Is that possible for this trip?

Be especially careful about what you eat and drink on Sunday and Monday because you’ll be going 3 days without dialysis instead of 2 and sometimes going 2 days without dialysis can put patients at higher risk of fluid overload which can be uncomfortable and make it difficult to breathe and having high potassium, which can be deadly. Your dietitian can be a great resource for helping you avoid those problems. Have you talked with your clinic to see if you can get the first shift on Tuesday? If not, I do that ASAP.

Home dialysis options, especially PD, are much easier to do when you travel. With enough notice, supplies can be shipped to the location where you’re traveling if you’ll be gone several days. If you need to go with little notice and you can travel by car, you can take the supplies with you. The PD cycler weighs about 25 lbs. and can be easily transported in a car or on a plane.

Standard HD machines are not portable, but there is a small HD machine that is used for short dialysis (called the NxStage) that is significantly smaller than the in-center HD machine. It weighs about 70 lbs., more in a travel case. It’s not easy for some people to lift it into a car by themselves, but others are able to do it with or without help. It can be transported in a case on a plane.

You might want to check out the information about treatment options, equipment for home HD and PD, and more from the Home Dialysis Central homepage (Home at the top of this page). Here’s an article about traveling with a PD cycler or NxStage machine.

Hi Beth,

Thanks (again - from another topic). Regarding my current plan, I will have dialysis at noon on Tuesday and again at my regular time on Wednesday. I make a normal amount of urnine and do not expect that to be a problem. Regarding diet, I am a light eater and am keenly aware of the potassium (and phosphorous) issues. I am on a renal diet for the most part and work hard to avoid the foods that are not on that diet.

Thanks again for the tips and the link for treatment options. I am in the states and if I go on home dialysis it will most likely be the NxStage machine which is what Fresinous offers. That is my current thinking for the moment. I’m not so sure PD is what I want to do.

The NxStage machine is made by a company called NxStage Medical Inc. (http://www.nxstage.com). The machine made by Fresenius is called the Fresenius 2008K@home (http://www.fmcna.com/fmcna/HomeTherapies/2008KHome/2008k.html). It’s shorter, but too heavy to be portable. I have known home HD patients with RVs who took their full sized HD machine with them on the road. That said, there are several companies making smaller machines, including one that’s a wearable kidney and several of them are in the FDA testing process. As time goes by, I expect to see even more choices of equipment (HD and PD) for people who want to travel.

Hi Beth,

It turns out that Fresinious offers the NxStage machine in our area. I guess that would be okay if you were traveling by car but it could be complicated and messy if by air.

Regarding other products in the pipeline, I’m anxious to see what is available - and there seems to be some innovative alternatives. However, I don’t see anything readily available for the next few years.

Thanks for your thoughts.

Ahhh…some Fresenius clinics do train people on NxStage machines. A number of patients report they have traveled by air with a PD cycler and NxStage machine.

You’re right that there are a number of products in the pipeline. They all have to go through clinical trials to assure they’re safe and effective and then be manufactured in large quantities. I suspect some are still trying to raise money to do all this.

A PD patient, even one who usually uses a cycler at home, can do CAPD (manual peritoneal dialysis exchanges) when traveling if he/she doesn’t want to take their cycler with them. Patients typically do CAPD 4 times a day (breakfast time, lunch time, dinner time, bedtime). I’ve known a number of patients who did a PD exchange at work in a private office or in a private bathroom or one that can be locked so no one can enter while the patient makes connections. Once connections are made, it usually takes about 20-30 minutes to do a PD exchange and the patient can be eating or working while draining and filling.

Baxter and Fresenius both manufacture PD equipment and supplies and both will deliver supplies to destinations for traveling patients with enough notice. Baxter is currently having a shortage of PD solution (expected to last until early 2015). This is causing delays in patient training in facilities that use their supplies. However, Fresenius doesn’t seem to be having the same problem with training delays.

For NxStage a trained resource is required, is it the case…CAPD however can be carried to travel or they can be delivered to desired designation for travel patients…