BLOOD PRESSURE MEASUREMENT IN KIDNEY TRANSPLANT RECIPIENTS AFTER ARTERIOVENOUS FISTULA LIGATION OR THROMBOSIS

Objective: Blood pressure (BP) measurement is a major issue in kidney transplant recipients (KTr). After transplantation, ligation or thrombosis of an arteriovenous fistula (AVF) is frequent, but its long-term impact on local hemodynamics remains unclear. In the absence of guidelines, BP is generally measured in the non-AVF forearm. This study aimed to evaluate the reliability of BP measurement and its relationship with local hemodynamic changes in this population. Design and method: We prospectively included 52 KTr with a history of unilateral AVF, at least one year after ligation (n=41) or thrombosis (n=11). Standardized BP measurements were performed twice simultaneously in both arms using StrideBP-validated devices. Peak systolic velocity (PSV) and humeral artery anatomy were assessed using ultrasound in both arms in a subset of 37 KTr. Statistical comparisons were conducted using paired t-tests. Results: Overall, no significant differences were observed between the AVF and contralateral arms in systolic BP (136.7±17.9 vs. 136.8±18.5 mmHg), diastolic BP (81.3±13.0 vs. 83.4±13.4 mmHg), or PSV (71.0±25.3 vs. 77.0±17.3 cm/s). Rare cases of BP discrepancies were associated with arterial stenosis or anatomical variations. Conclusions: Blood pressure can be reliably measured in either arm after AVF ligation or thrombosis in kidney transplant recipients. Incorporating this practice into routine care may simplify BP monitoring, with ultrasound evaluation reserved for cases with significant inter-arm discrepancies.