Chand DH et al. - In this article, the status of vascular access is described in the United States and worldwide in children, the importance of AVF creation, and the need for surgical expertise, including microsurgery, in this population. Additionally, we introduce the International Pediatric Fistula First Initiative, a multidisciplinary team consisting of pediatric nephrologists, vascular access surgeons, and interventional radiologists aiming to increase awareness, offer educational tools, and implement the fistula first initiative in children.
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