Chronic kidney disease (CKD) and end stage renal disease (ESRD) are worldwide public health problems.(1)The prevalence of CKD (stages 1-5) in the general United States adult population was 14.8% in 2013-2016,
CKD and ESRD patients have increased risk of functional impairment, regardless of their age, gender, associated co-morbidities, and cardiovascular events.(3)
This high level of functional limitations in patients with CKD and ESRD is not necessarily improved by dialysis. Rehabilitationprinciples need to be integrated into the routine management of patients. (5)Rehabilitation of CKD and ESRD patients involves many aspects as psychological, nutritional, and exercise training.(6)
Various exercise programs, such as aerobic exercise, resistance exercise, combined aerobic and resistance exercise, and passive exercise including electrical stimulation have been developed for hemodialysis patients
The aim of the current study was to assess the effect of intradialytic aerobic training on physical performance and quality of life in patients maintained on haemodialysis therapy.

The study included thirty patients on maintenance hemodialysis therapy for more than three months in Alexandria University Hospitals.
Patients were divided into two groups:
Group (A): Fifteen patients performed exercise during hemodialysis session.
Group (B): Fifteen patients were not assigned to any exercise program (as a control group).
Mentally or physically unfit patients,patients with overt ischemic heart disease or cardiac decompensation, severe anaemic patients (Hb ≤ 8 g/dl),patients with advanced chronic kidney disease-mineral and bone disorder (CKD-MBD), patients with advanced lower limbs joints disease or amputation of lower limb were excluded.