الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The best VA, besides delivering suitable blood flow, should have adequate patency and less frequency of complications. The arteriovenous fistula (AVF) best approaches this definition Unfortunately, the access used most frequently in children in the USA is the central venous catheter (CVC) opposite to an AVF or arteriovenous graft (AVG). Although the increasing focus on the possible morbidity associated with CVCs, their usage frequency at hemodialysis beginning has increased in last years, with usage rates of 89% for children <13 years of age and 64% in those 13 to19 years. Methods: This is a prospective descriptive longitudinal non randomized study with analytical component that was conducted on 120 patients ( 66 males and 54 females) aged 2 – 19 years suffering from chronic renal failure attending to Vascular surgery department at Mansoura university hospital between January 2017 to December 2018 who was selected for AVFs and permenant central venous catheters (CVC) and gave written and informed consent.
Results: The study shows statistically significant difference between primary patency and secondary patency of arteriovenous fistulas and permanent central venous catheters and statistically significant difference in complication rate as regard infection, thrombosis,access failure and death.Conclusion Vascular access in the pediatric hemodialysis patients is a challenging, but essential, affair for the practitioners. It calls for proper advanced planning to make sure that the best permanent vascular access is placed, communication involving a multi-disciplinary team of nephrologists, surgeons, and interventional radiologists, nurses and ongoing monitoring to guarantee its long survival.