Clinical Research Directory

Inclusion Criteria: All patients were included according to the following criteria: 1. Age between 50-60years. 2. The patients had been on hemodialysis for at least 3 months with three sessions per week for 3-4hr per session. 3. The patients were diagnosed with end stage renal failure (stage5 CKD) on maintenance regular HD (three sessions/week (on alternate days), for four hours/session) for more than three months. (Receiving HD through uncomplicated arm arteriovenous (A-V) fistula 4. Under medical control 5. Both men and women were enrolled 6. Body math index ranged from 18,5- 24.9 kg/m² Exclusion Criteria: Patients who experienced or had one or more of the following were excluded from the study: 1. Patients with resting systolic blood pressure \>200 mmHg and/or diastolic blood pressure \>120 mmHg. 2. patients with neurological problems (e.g. stroke, head injury) 3. patients with musculoskeletal problems (e.g. sever osteoarthritis or difficulties in ambulation) 4. Patients with uncontrolled pulmonary disease. (e.g. exaggerated chronic obstructive pulmonary disease, acute asthma) 5. Patients with mental health problems and cognitive impairment due to inability to teach them how to make respiratory training. 6. Any patient who missed more than two weeks of the program or want to terminate the program. 7. Severe obesity (BMI \>35) 8. Presence of malignant disease. 9. Patients with unstable angina, uncontrolled cardiac arrhythmia, decompensated heart failure, acute pericarditis or myocarditis. 10. The patients had hearing impairment or mental disorders.