Adequate fluid management is an important therapeuticgoal of dialysis. Recently, bioelectrical impedancemethods have been used to determine body fluid status, but pediatric reports are rare. To determine the accuracy of bioelectrical impedancemethods in the assessment of body fluid statusof children undergoing hemodialysis (HD), 12 children on HD were studied. A multi-frequency bioimpedance analysisdevice (Inbody S10) and bioimpedance spectroscopydevice (BCM) were used to evaluate fluid status. Fluid removal during a HD session (assessed as body-weight change, ΔBWt) was compared with the difference in total body water determined by each device (measured fluid difference, ΔMF), which showed strong correlation using either method (Pearson's coefficient, r = 0.772 with Inbody S10 vs. 0.799 with BCM). Bioimpedance measurement indicated fluid overload (FO; ΔHS greater than 7%) in 34.8% with Inbody S10 and 56.5% with BCM, and only about 60% of children with FO by bioimpedance methods showed clinical symptoms such as hypertension and edema. In some patients with larger weight gain Inbody S10-assessed overhydration (OH) was much smaller than BCM-assessed OH, suggesting that BCM is more relevant in estimating fluid accumulation amount than Inbody S10. To our knowledge, this is the first report on the use of body composition monitors to assess fluid status in Korean children receiving HD.