What to do if something goes wrong: emergencies and complications while dialyzing abroad

Every other post here is about planning ahead so nothing goes wrong. This one is about what to do when something does. Not because it's likely, most trips go exactly as planned, but because the cost of being unprepared for the one that doesn't is high enough that it's worth ten minutes of thinking through now, while you're calm and at home, instead of later.

Before you go: build the kit you hope you never open

The single most useful thing you can do is assemble a short document and keep it somewhere you'll actually have it, your phone, a printed copy in your bag, not just in an email you can't access without signal.

• Your diagnosis, dialysis modality, schedule, and dry weight
• Your vascular access type and any relevant history (previous clotting, revisions, infections)
• Current medications and dosages
• Allergies
• Your nephrologist's name and a phone number or email they'll actually check while you're away
• Emergency contact for someone back home who knows your medical history

Ask your care team to write a short summary letter in English (or in the language of your destination, if different) covering the same points. A one-page letter from a doctor carries far more weight with a foreign hospital than you explaining your own history through a translation app.

If you miss a session

Missing a scheduled session is not the same emergency for everyone; how much it matters depends on your kidney function, your fluid status, and how long the gap is. What matters is having a plan instead of guessing:

• Contact the clinic you were scheduled with first. Many can fit you in later the same day or the next, especially if you call rather than email.
• If you can't reach them, contact your home nephrologist. They can tell you, given your specific situation, whether this is a same-day problem or something you can safely push by a day.
• Watch for the signs your care team told you to watch for: shortness of breath, significant swelling, confusion. Those mean go to a hospital, not wait for a scheduled slot.

If your access has a problem

A fistula or graft that's not working right, or a catheter site that looks infected, is not something to wait out in a new country. Go to a hospital or urgent care immediately, and bring your access history if you have it, prior surgeries, revisions, what's normal for your site. A clinician unfamiliar with your case will move faster and more safely with that information in hand than without it.

If you're on a catheter, know the signs of a line infection before you travel: redness, warmth, drainage, or fever at the site. These can escalate quickly and are not a "wait until tomorrow" situation anywhere, let alone somewhere unfamiliar.

If you end up in a hospital, not a dialysis clinic

Sometimes the emergency isn't dialysis-related at all, a fall, food poisoning, anything that lands you in a general hospital. If that happens while you're mid-trip:

• Tell them immediately that you're on dialysis and when your next session is due. This changes what medications and fluids they can safely give you.
• Hand over your summary letter and medication list. It saves time that matters.
• If you're admitted for more than a day or two, someone there should be coordinating with a dialysis unit for you, don't assume it will happen on its own; ask directly who is arranging it.

Know your evacuation options before you need them

Check what your travel insurance actually covers for medical evacuation, and specifically ask whether pre-existing conditions like ESRD are included, some policies exclude them by default and require an add-on. If a real complication happens somewhere with limited care options, evacuation coverage is the difference between a manageable situation and a very expensive one on top of an already hard day.

The honest reassurance

None of this is meant to make dialyzing abroad sound risky, most trips go completely fine, and clinics that treat traveling patients handle unfamiliar cases regularly. The point of preparing for the bad day is exactly so you don't have to think about it on the good ones.

If you'd rather not be the one figuring out which clinic to call when you're already stressed, KidneyTrip's directory lets you save contact details and confirmed clinics for your destination before you ever need them. And if you want someone already coordinating your care on the ground, the Managed Service keeps a point of contact in place for the whole trip, not just the booking.

Plan for the trip you expect. Just don't leave the other one completely unplanned.