Tips for Traveling With C3G/IC-MPGN

Traveling while you have a severe kidney disease like complement 3 glomerulopathy (C3G) or immune complex-membranoproliferative glomerulonephritis (IC-MPGN) can be possible, even if you’re receiving dialysis. It does require advance planning and preparation, especially if you have to coordinate with healthcare teams overseas.

"People with chronic kidney disease will benefit from checking in with their nephrologist about safe travel, as needs vary by disease stage and comorbidities,” says Heather Ratliff, DO, associate chief clinical officer at Fresenius Kidney Care.

Regardless of the stage of your kidney condition, travel requires careful planning. You need to keep taking your medicine on schedule, stay hydrated, and maintain a kidney-friendly diet, per your doctor’s and registered dietitian’s instructions. Sticking with your treatment plan and taking appropriate precautions, however, can help you have a safe and enjoyable trip.

Pack a Travel Kit for C3G/IC-MPGN

• Medication Bring enough of all of your medication to last the entire trip plus a few extra days, just in case there are delays. “Keeping medication and medical records in carry-on luggage is helpful for managing disruptions, time zone changes, and emergencies,” Dr. Ratliff says.

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• Medication List Have a printed medication list that includes all of your medications and dosing information, and keep a backup on your phone. Include the names of two or three emergency contacts, too. A note from your nephrologist describing your diagnosis can also be a good idea.

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• Lab Reports “A copy of your recent lab reports and last measurements of kidney function is important,” says Matthew Weir, MD, the head of the nephrology division at the University of Maryland Medical Center and a professor of medicine at the University of Maryland School of Medicine in Baltimore. “If you get sick and end up at the hospital, and there’s a change in kidney function, it’s good to know if it’s a new development. This is very helpful to have, as not all medical records are available electronically everywhere in the world.” A note from your nephrologist describing your diagnosis can be helpful, too.
• Sanitizing Supplies If you are taking immunosuppressants or dialysis, which can weaken your immune system, you may be more prone to infection. Packing hand sanitizer, disinfectant wipes, and masks, as well as practicing good hygiene, can help reduce this risk.

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• Monitoring Devices These might include a portable blood pressure monitor if you have high blood pressure or an insulin pump, continuous glucose monitor, batteries, and meters if you have type 2 diabetes. A digital thermometer to monitor for fever is also helpful.

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• Snacks and Drinks “Carry kidney-healthy snacks so you can avoid overly salty things typical in convenience stores, vending machines, and airport kiosks,” says Alex Courville, MD, a family medicine doctor and owner of The Kinder Clinic in Kinder, Louisiana. Pack bottled water to stay hydrated; you will have to buy it after passing through security if you are flying. Adequate hydration is essential for healthy kidneys, and you must tailor your fluid intake to your kidney function and stage of disease.

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Manage Medications on the Move

Organizing medications and figuring out time zone changes ahead of your trip can help avoid confusion later on. Talk to your doctor about the best plan for taking medication if you are crossing time zones, especially for medication that you take more than twice a day.

“If you are on a twice-a-day schedule, keep track of the times and just continue morning and night,” says Dr. Weir, adding that it’s often wise to try to keep them 12 hours apart. “If you’re off for a few hours, that’s generally okay,” he says.

If traveling by plane, pack all of your medicine in your carry-on,  not in checked luggage. This way, you have access to your medicine en route, and it is less likely to get lost in transit. Use the original, labeled containers for medications, even for domestic travel.

Travel can be hectic, and you don’t want to miss a dose of your medicine. Setting an alarm on your watch or phone can remind you when to take your medication, especially on a longer flight. For example, you can use a 12-hour timer to keep your medication intervals consistent as you cross time zones. Medication reminder apps are also available.

International Travel

• Make sure that your medication is in your carry-on luggage and stored in its original, labeled container with your full name, healthcare provider’s name, generic and brand medication name, and exact dosage.
• Have written copies of all prescriptions, including the generic names of the medicines. Give a copy to a family member or friend in case you misplace yours or need an emergency refill.
• Get a note from your doctor if you are using any injectable medicine or a controlled substance.
• Make sure that all your medications are permitted at your destination. Ask your healthcare team for help.

Preventing Infection

Take the following steps to prevent infection:

• Wash your hands often and use hand sanitizers if soap is not available.

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   Use disinfectant wipes to clean frequently touched areas such as tray tables on airplanes and seat armrests, as well as hotel remote controls and light switches.

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• Make sure that you are up-to-date on all recommended vaccines, including any that your doctor recommends for your destination.

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• If you are receiving hemodialysis, follow your dialysis care team’s instructions for keeping your access site clean and protected. This may include washing a fistula or graft as directed, keeping a catheter dressing clean and dry, and avoiding tight clothing, heavy items, or anything else that puts pressure on the access area.

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• Consider using bottled water, even to brush your teeth, if you are traveling to an area with poor sanitation. Avoid ice that is not made with bottled water and raw foods, including raw fruit washed in local water. Opt for fruits with a thick skin that you can peel off.

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What Happens if You Get Sick?

Talk to your doctor before your trip about how to prepare for potential illness.

“Some people do get sick on the road, and gastroenteritis is common,” Weir says. “There are certain medications that we recommend be stopped if you become seriously ill. These include some blood pressure medicines, SGLT2 inhibitors, and medications that lower glucose levels.”

Do not stop taking insulin, he says. But talk to your doctor about adjusting your doses.

“Basically, if you’re not eating and are volume depleted, you may need to cut back on different medications,” says Weir, adding that it’s wise to talk to your care team about potential medication interactions, as well.

Your doctor may also recommend taking prophylactic antibiotics based on your medical history. “If you’ve had a recent transplant, for example, or depending on the medication you are taking, like immunosuppressants, or the type of travel you’re doing, antibiotics might be recommended,” Dr. Courville says. “You may also consider asking about antidiarrheal medications because unfamiliar food can lead to gastrointestinal upset and subsequent dehydration, which is a concern for anyone but especially travelers with chronic kidney disease.”

Traveling on Dialysis

If you are receiving dialysis treatment, discuss your travel plans with your doctor and ask for guidance.

“In general, people on dialysis should maintain their prescribed treatment schedule as closely as possible when traveling,” Ratliff says. “For some, receiving dialysis shortly before departure may be appropriate, particularly for longer trips or international travel, but the best timing depends on the person’s treatment plan, itinerary, and overall health.”

“We encourage patients on dialysis to work with their care team several weeks before traveling to arrange treatments at their destination, confirm insurance coverage, and prepare for unexpected interruptions,” Ratliff says. “Stretching the time between treatments or delaying a scheduled treatment could pose serious health risks.”

Have your most recent lab results and medical records on hand in case the treatment center at your destination requires them.

“People on home dialysis, including peritoneal dialysis and home hemodialysis, should coordinate closely with their care teams and often have more flexibility to travel with proper planning, as they can receive treatment wherever they can safely bring and use their equipment and supplies,” Ratliff says.

Optimize Nutrition on the Go

Eating healthy meals while on the road with a kidney condition such as C3G or IC-MPGN takes some extra planning to stay on track.

“The great news is that being prepared makes healthy eating completely doable and less stressful,” says Beverly Garden, RD, who specializes in renal nutrition in Selinsgrove, Pennsylvania.

She offers tips on how to stick with your eating plan while traveling:

• Review restaurant menus. Scope out the restaurants that you may visit to plan your meals. Some menus even include nutrition information. “Examples of good meal choices include grilled foods without added salt and sauces; salads without salty additions such as cheese, bacon bits, and croutons; and those with vinegar and oil dressing or dressing on the side,” Garden says. It can be helpful to call ahead to speak to a manager about preparation methods and the restaurant's willingness to accommodate special requests, such as replacing sauces or removing ingredients.
• Prepare your own meals. Choose a hotel or vacation rental with a refrigerator, microwave, or even a kitchenette so you are not always eating out. “Restaurant foods are often high in sodium, which can worsen swelling, thirst, and blood pressure,” Garden says.
• Map out grocery stories. If you plan on cooking while traveling, choose accommodations that are near grocery stores that will likely have the ingredients you need. Easily accessible grocery stores also make it convenient to stay stocked up on proper snacks.
• Pack snacks. Bring reliable, kidney-friendly options so you are not dependent on airport or gas station food, and can supplement meals. Examples of nonperishable healthy snacks include dried fruits, plain popcorn, and portion-controlled unsalted nuts.

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• Stick to your schedule. “Try not to skip meals, especially if food needs to line up with medications or treatments,” Garden says. “Eating regular meals and snacks can help prevent excessive hunger, which can lead to over indulgence or not being as careful with your food choices.”

Talk to your doctor and a registered dietitian about the meals that work best for you.

Emergency Care When Traveling

Research local healthcare facilities and emergency services at your destination to know the location of the closest facility.

Check your destination for any specific health risks and safety concerns, especially if you are traveling internationally. The Centers for Disease Control and Prevention tracks global health concerns and issues alerts. Talk to your healthcare provider at least a month before your trip about receiving any destination-specific vaccines or medication.

Being honest about your health can also help prevent problems before they happen, Courville says. “Plenty of patients with chronic kidney disease that is managed and stable can live a normal life,” he says.

The Takeaway

• Traveling safely with complement 3 glomerulopathy or immune complex-membranoproliferative glomerulonephritis requires close coordination with your care team to ensure that you have the medication you need when you need it.
• Pack a comprehensive travel kit that includes all of your medications in their original containers, recent lab reports, a medication list with emergency contacts, and sanitizing supplies to reduce infection risk.
• If you're on dialysis, arrange treatment at your destination at least six to eight weeks before your trip and verify your insurance coverage, especially if you are traveling internationally.
• Delaying or skipping dialysis treatments poses serious health risks, so maintaining your prescribed treatment schedule is essential.