Dialysis during a stay in Morocco: how do you arrange your sessions and travel safely?

Why dialyse in Morocco during a stay?

Several situations lead a dialysis patient to plan sessions in Morocco:

• they are coming for treatment of another condition, for example surgery or heart disease, and their sessions must be coordinated with the rest of their care;
• they are accompanying a relative in hospital;
• they are staying in Morocco for family or personal reasons.

When the stay includes a hospital admission, dialysis is organised by the nephrology team in liaison with the other specialists. Sessions may need to be adjusted around an operation or a test with contrast agent.

The file requested by the dialysis centre

The exact list depends on the centre. It usually includes:

• a letter from the nephrologist caring for the patient, with the cause of kidney failure and the main medical history;
• the dialysis prescription: number and length of sessions, type of dialyser, flow rate, dialysate composition, anticoagulation, dry weight;
• a description of the vascular access: arteriovenous fistula, graft or catheter, and its side;
• recent tests: haemoglobin, potassium and usual blood tests;
• recent serology for hepatitis B and C and HIV, and hepatitis B vaccination status;
• the list of treatments, including those given during sessions, and allergies;
• the latest session records, which show usual tolerance.

Serology allows the centre to arrange the patient’s care according to its infection-prevention rules. A result that is too old may lead the centre to repeat the tests on arrival.

Booking the sessions

The centre must confirm the dates and times of sessions before departure. It is wise to allow a margin in case the stay is extended, and to know in advance whom to contact if a flight is delayed. Unplanned extra sessions, particularly in the event of fluid overload, must be possible to arrange.

Preparing the journey

Timing

A flight scheduled shortly after a session allows the journey to be made in good conditions. A flight at the end of the interval between two sessions exposes the patient to fluid overload and a rise in potassium, especially if there is a delay. The first session in Morocco should be planned without excessive waiting after arrival.

Diet and fluids

During the journey, the usual restrictions still apply: limit drinks according to the prescription, avoid foods rich in potassium and salt, which are often harder to control in meals eaten out. Heat can increase thirst.

The fistula

The fistula must be protected: do not carry a heavy bag or wear a tight bracelet on that arm, and do not allow blood pressure to be taken or blood to be drawn from it. The patient checks every day that the fistula’s thrill can be felt; if it disappears, medical attention must be sought promptly.

Treatments

Usual medicines, such as phosphate binders or anaemia treatments, are taken in sufficient quantity, with prescriptions. Some medicines must be kept cool during transport.

What about peritoneal dialysis?

A patient on peritoneal dialysis can also travel, but must arrange the supply of bags and equipment on site, as well as the hygiene conditions needed for exchanges. Their dialysis team helps them prepare the stay.

Signs that require prompt medical attention

Breathlessness, severe swelling of the legs, rapid weight gain between sessions, palpitations, unusual muscle weakness, fever, redness at the access site or disappearance of the fistula’s thrill require medical attention without delay.

Frequently asked questions