Introduction: Chronic renal failure is an incurable disease we treat with hemodialysis and peritoneal dialysis in children with an appropriate vascular approach. If possible, kidney transplant is performed. Purpose: We present ways of treating chronic kidney disease and the types and care of vascular approaches. Methods: We used a descriptive method of working with a systematic review of professional and scientific literature in Slovene and English, in the period from 2005 to 2022. Literature was sought in Slovenian with keywords: child, chronic renal failure, arteriovenous fistula, central venous catheter, dialysis catheter and in English with phrases: kidney failure AND children, vascular approach AND kidney failure, nursing care AND dialysis vascular approach in the following databases: Medline (PubMed), CINAHL, The Cochrane Collaboration, and according to the bibliographical-catalogue database of Slovenian libraries (COBIB.SI) via remote access of the Faculty of Health Sciences in Ljubljana. We included 57 articles in the analysis. Results: There are three types of vascular approaches: central venous catheter, arterio-venous fistula, and arterio-venous graft. Children diagnosed with chronic renal failure are immediately placed on a transplant waiting list, but must be dialyzed until it is their turn. If dialysis is short-term (temporary), the central venous catheter is the first choice of vascular approach, but if it becomes long-term, it is necessary to construct an arterio-venous fistula. An arterio-venous graft is established only when a child has poor blood vessels. The role of the nurse is very important in all vascular approaches, as she must be present during the procedures and at the same time be careful not to cause any complications. Discussion and conclusion: A review of professional literature revealed there are three ways of vascular approaches to perform hemodialysis. Nurse plays an important role in this, as she must pay close attention to children who are most frequently treated with the dialysis catheter approach to avoid any infection. In case of arteriovenous fistula, she must master correct technique of puncture and puncturing in order to maintain mentioned vascular approach for as long as possible. Arterio-venous graft comes into play in children with poor blood vessels.
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