Esophageal motility was studied in 16 asymptomatic hemodialysis patients and 38 normal volunteers. The incidence of triphasic tertiary and biphasic contractions was significantly higher in the patients than in the control subjects (25 vs. 0% and 87.5 vs. 39.5%, respectively). The above abnormalities were recorded in the lower two thirds of the esophageal body. We suggest that manometric evidence of esophageal dysfunction is very common in such patients. Although the pathogenesis is unclear, uremic neuropathy of the vagus nerve and/or smooth muscle myopathy due to chronic uremia could be the causative factors.