Abstract: Objective The aim of the study was to report our experience with arteriovenous fistulas (AVFs) in children and adolescents with end-stage renal disease (ESRD) on hemodialysis(HD).Assess the complication rates of and reasons for access failure in a group of children on HD Methods This was a retrospective cohort study to assess HD vascular access type, complications and causes of failure in children aged less than 18 years, who started HD during the 2006.1-2012.1 period. 19 children (7 females, 12 males) with ESRD received HD treatment. Hemodialysis was an initial renal replacement therapy in 16 out of the 19 children. Results 31 accesses were studied in 19 patients.A total of 21/31 (67.7%) of the AVFs were placed in the left forearm, 7/31 (22.6%) of them in the right forearm,and3/31 (9.6%) in the cubital fossa. AVF primary failure was detected in 22.6% of the fistulas. The complications of the remaining 77.4% (24/31) of the functionalAVFs were thrombosis in 4/24 (16.7%),stenosis in 1/24 (4.2%), aneurysm formation in 1/24(4.2%),High output in 1/24 (4.2%),venous hypertension in 1/24 (4.2%),The main cause of failure of the functioning AVFs was thrombosis (84%). Patients` mean age at AVF creation was 12.21±3.17 years（7-17 years）. Mean weight was 31.16±9.85Kg（16.7-45.4 Kg） The mean time from the construction of the AVF to its usage for hemodialysis was9.84±5.6weeks （4-25weeks）.The mean patency of the AVF was 18.95±17.32months （3-64 months）. Conclusions AVF usage rates and longterm patency rates can be quite high with proper vascular access team and microsurgery in gaining paediatric vascular access. Keywords: Pediatric hemodialysis Arteriovenous fistula construction

Key words: Pediatric hemodialysis, Arteriovenous fistula construction