Background: Due to the limited availability of kidney transplants and the increasing number of patients on waiting lists, dialysis remains the primary treatment for children with end-stage renal disease. Vascular access, particularly arteriovenous fistula (AVF), is a key method for long-term hemodialysis, but it presents challenges in pediatric patients under 10 years old. This study aimed to evaluate the outcomes and complications of AVF creation in this age group.

Methods: This retrospective, cross-sectional study was conducted on 25 children with ESRD who underwent AVF creation between 2016 and 2020. Data collected included demographics, type of AVF created, and complications associated with the procedure. Descriptive statistical analysis was performed on the data.

Results: Among the 25 children, 9 (36%) experienced complications related to AVF. The most common complications were AVF immaturity (6 patients, 24%), thrombosis (2 patients, 8%), aneurysm (2 patients, 8%), hemorrhage (1 patient, 4%), and no infections at the surgical site. During follow-up, 4 patients (16%) received kidney transplants, and 5 patients (20%) required additional interventions to create new hemodialysis access.

Conclusion: The results of this study show that complications related to AVF creation are more frequent in children under 10 compared to adults. Therefore, the use of alternative access methods, such as central venous catheters, to preserve the veins for future fistula creation and to avoid severe complications in children is recommended.