Establishment of vascular access: Pediatric blood vessels are fine and difficult to cooperate, the key to successful blood purification is the establishment of good vascular access. Whether it is a suitable choice for acute renal failure, chronic renal failure waiting for the maturation of arteriovenous fistula, temporary vascular access needs to be established, and central venous cannulation is mainly applied at present. Femoral vein cannulation, internal jugular vein, and subclavian vein cannulation are commonly used. Currently, internal jugular and femoral vein cannulation is commonly used in pediatrics. The most important complication of central venous cannulation is infection, foreign countries have reported m1 195 patients with temporary venous cannulation average retention time of 35.7 d, infection rate of 9.6 cases, 1000 catheter days. Semi-permanent vascular access refers to central venous cannula with cuff reported the longest application of 11 months (average 117 d) in 19 cases of children, 10 cases of combined infection, catheter thrombosis in 6 cases. Permanent vascular access pediatrics to autologous subcutaneous arteriovenous anastomosis endovascular fistula is preferred, our hospital selected the cephalic vein and radial artery end lateral anastomosis, the success rate is 93%.