Effect of Intradialytic Resistance Versus Aerobic Exercise on Cardiovascular System in Patients on Regular Hemodialysis

Inclusion Criteria: * End-stage renal disease (ESRD) or stage 5 chronic kidney disease (CKD) in which on maintenance regular HD (three sessions/week (on alternate days), for four hours/session for more than a year to five years when starting the study. * Both gender male and female aged from 45 to 60 years old. * Patients with intradialytic hypotension sudden drops of systolic pressure of more than 20 mm Hg or diastolic pressure of more than 10 mmHg. * Receiving hemodialysis (HD) through uncomplicated arm arteriovenous (A-V) fistula. * Patients with Body Mass Index (BMI): 18,5 \< 30kg/m2. * In a stable medical, clinical, and hemodynamic condition * Untrained at baseline and did not participate in any regular physical activity before. Exclusion Criteria: * Severe Chest diseases (either obstructive or restrictive). * Clinical signs of a severe cardiac event. (eg, severe atherosclerosis, congestive heart failure), * Severe psychiatric or cognitive impairment, who unable to follow comment. * Neurological disorders affecting respiratory muscles or any muscular dystrophies (cervical disc or bulge). * Patients with severe self-limiting illness (e.g., cancer). * Patients with Body Mass Index (BMI) \> 30kg/m2. * Previous renal transplantation patients. * Pregnant females or became pregnant during the study. * Patients started HD in less than a year or more than 5 years. * Hospitalized during the prior month. * Patients who were irregular in HD or not adherent to the exercise progra…