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Introduction: In 2001 our Renal Dialysis Unit underwent a major renovation to five stations. The new space and funding allowed for acquisition of new state-of-the-art hemodialysis machines. We describe our experience with the Gambro Phoenix with Diascan and Exalis. Prior to the move an evaluation was undertaken. Criteria for selection with a scoring tool were utilized to rate machine performance for use in children. The decision for the Gambro Phoenix machine was based on: the performance rated highly due to ease of set up; large viewing touch screen; compatibility with existing equipment; benefits of online clearance monitoring (Diascan); network data management system (Exalis) and the future availability of blood volume monitoring (Hemoscan). Our program was the first center to dialyze a pediatric patient on the Phoenix machine in Canada. Patients and results: 13 patients (age 2–23 years) were hemodialyzed between May 2002 and September 2003 for periods of 2 week to 16 months, greater than 5000 h of dialysis time. The move was not uneventful. During the first months of operation issues such as inadequate electrical supply for the new machines, reverse osmosis (RO) pump failure, leaks, and no emergency power to the RO were prevalent. The new software also exposed glitches. Subsequent Phoenix use proceeded uneventfully. Staff were able to problem solve easily with clinical and technical support from Gambro Canada. Education for the online clearance monitoring, Diascan and Exalis, was necessary. No major problems with dialysis were encountered. The benefits and reliability of Diascan have been previously described (Lindsay RM, Sternby J, Semin Dial. 2001; 14:300). Diascan readings provided real-time measurement of sodium (Na), which correlated well with laboratory values. Automatic readouts of Kt/V allowed for monitoring of dialysis adequacy which was consistent with calculated percent reduction in urea (PRU). At this point, use of the Phoenix has been demonstrated to work well in a pediatric facility.