Choice of VA represents a challenge in the organization of care for these patients, from determining how long the patient will be receiving hemodialysis, to choosing the type of VA best suited to preserve the vascular bed,while avoiding AVF if short dialysis durations are envisaged.
In our experience, we conclude that despite the policy change, which has shortened hemodialysis duration time considerably, the median duration on hemodialysis is still too long and AVF should still be first choice of VA in children with ESRD.