In 10 patients with chronic renal failure (CRF), undergoing hemodialysis, we studied respiratory muscle strength and endurance. The data obtained was compared with those acquired from 10 age-, sex-, weight- and height-matched normal volunteers. Maximal static inspiratory pressures (PImax) measured at residual volume and maximal static expiratory pressures (PEmax) measured at total lung capacity were significantly lower in the CRF group, 58.2 ± (SD)24.9 and 50.8 ± (SD)24.2% of predicted, respectively (p < 0.005, p < 0.01). There was a significant correlation between PImax and PEmax (r = 0.827, p < 0.001), indicating similar involvement of both inspiratory and expiratory muscle groups. Maximal voluntary ventilation (MVV), although 84.4% of the predicted value in the CRF group, was significantly lower than in the control group, where it was 114% of predicted (p < 0.001). MVV also correlated significantly with PImax and PEmax (r = 0.764, p < 0.001 and r = 0.807, p < 0.001, respectively). All but one CRF patient had elevated serum inorganic phosphorus levels, and a significant correlation was found between the serum inorganic phosphorus levels and PImax and PEmax (r = 0.718, p < 0.001). These data indicate that there is an impairment of respiratory muscle strength and endurance in patients with CRF which may predispose the patient to respiratory muscle fatigue