Exercise Training Versus Ropinirole in Treating Restless Legs Syndrome Among Hemodialysis Patients

Inclusion Criteria: * Adult patients aged 18-60 years. * Both male and female. * Diagnosed with end-stage kidney disease (ESKD) and currently undergoing twice weekly maintenance hemodialysis for at least 3 months. * Diagnosed with restless legs syndromeas defined by the International Restless Legs Syndrome Scale (IRLSS) criteria, with an IRLSSscore of 10 or higher at baseline. * Able to participate in physical exercise as assessed by a healthcare professional. * Patients must exhibit normal serum electrolyte levels, including potassium (3.5-5.0 mmol/L), calcium (8.5-10.2 mg/dL), phosphate (2.5-4.5 mg/dL), magnesium (1.7-2.2 mg/dL), and intact parathyroid hormone (iPTH) (150 to 600 pg/mL), as confirmed by recent laboratory tests. Exclusion Criteria: * Presence of other medical conditions that significantly impair mobility (e.g., severe arthritis, recent fractures, or amputations). * Patients diagnosed with other neuropathies as assessed by neurologists. * Patients in catabolic state with active infection, inflammation (C-reactive protein blood levels above 5.0 mg/l) or malignancy. * Patients with diagnosed iron deficiency, defined by transferrin saturation less than 20%. * Patients diagnosed with myocardial infarction or unstable angina over the last twelve months, existing heart failure or liver disease, poorly controlled diabetes (RBS ≥ 250 mg/dl) and uncontrolled hypertension with systolic blood pressure≥200 mmHg and /or diastolic blood pressure≥120 mmHg on two separate …