In a patient with an old arteriovenous fistula (AVF) on the left arm, is it safe to use that arm for routine blood pressure measurement? | Rounds In a patient with an old arteriovenous fistula (AVF) on the left arm, is it safe to use that arm for routine blood pressure measurement? | Rounds
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In a patient with an old arteriovenous fistula (AVF) on the left arm, is it safe to use that arm for routine blood pressure measurement?

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Last updated: July 14, 2026 · View editorial policy

Blood pressure measurement in an arteriovenous fistula arm

Blood pressure measurement with a cuff on the hemodialysis arteriovenous fistula (AVF) access arm is not recommended because access-arm protection is advised during vascular access care. [1-3]

Safety consideration

Dialysis-access patient education materials advise avoiding blood pressure cuffs on the access arm. [1-3]

  • Blood pressure should be measured on the non-access arm. [2,3]
  • If the non-access arm cannot be used, alternative-site measurement strategies should be used per the clinical setting rather than using the AVF arm cuff. [2]

Practical implementation

When an AVF is present, routine care should document the access arm and specify that blood pressure cuffs should be avoided on that limb. [1-3]

Clinical nuance

The specific instruction is tied to a functioning hemodialysis AVF used for vascular access care. [1-3]

Potential harms prompting avoidance

Avoiding cuff inflation over the AVF is part of vascular access protection guidance given to patients. [1-3]

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