From Dialysis to Destinations: Safe Travel Strategies for Patients With CKD

Abstract

Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) represent growing global health burdens, driven by aging populations and increasing prevalence of diabetes and hypertension. Patients with ESKD face significant lifestyle limitations, particularly regarding mobility and travel, because of treatment schedules, medical complexity, and heightened vulnerability to complications. Air and longdistance travel pose distinct risks-cardiovascular stress, infection, and logistical challenges-that demand tailored assessment and preparation. This review outlines key travel-related complications in CKD and patients on dialysis, including cardiovascular and thromboembolic events, infection, jet lag, and vascular access risks. It further examines aeromedical considerations, such as hypobaric hypoxemia and venous thromboembolism (VTE), and evaluates airline-specific medical clearance protocols in major global carriers. Detailed recommendations are provided for hemodialysis and peritoneal dialysis (PD) patients, including pre-travel assessment, medication and supply management, international dialysis coordination, and inflight precautions.