Abstract Speciation of arsenic was determined in serum of 19 non-hemodialysis (non-HD) and 18 HD patients. The respective mean values of serum creatinine in these groups were 410 +/- 250 and 914 +/- 173 mumol/L (reference range for healthy subjects: females 50-80; males 57-93 mumol/L). The mean total arsenic concentrations were 5.12 +/-5.58 and 6.47 +/- 4.28 micrograms/L, respectively (reference value: 0.958 +/-1.52 micrograms/L). Dimethylarsinic acid (DMA) and arsenobetaine (AsB) were the major As species in serum of the non-HD and HD patients, with mean values of 0.82 +/- 1.05 and 1.93 +/- 1.51 micrograms/L for DMA and 3.55 +/- 4.58 and 3.47 +/- 2.89 micrograms/L for AsB, respectively. Serum concentrations of inorganic As and monomethylarsonic acid in both groups were below the detection limits for these compounds. Measurement of As concentration before vs after 4 h of HD treatment indicated that 68% of total As in serum was removed, as was 16% of the total As in packed cells. The efficiency of DMA and AsB removal during dialysis corresponded to that of total As.