Intradialytic Pedalling Exercise and Vascular Hemodynamic Parameters Among Prevalent Hemodialysis Population

Inclusion Criteria: * Adults with end-stage renal disease (stage 5 CKD), who were on a stable in-center hemodialysis regimen (approximately 4 hours 3 times per week) for ≥ 12 weeks prior to recruitment * A cardiac evaluation was required within the last year to ensure adequate cardiac function Exclusion Criteria: * Any physical or psychological disability that would impact study participation, such as severe cerebrovascular disease (e.g., hemiparesis, cerebellar ataxia, etc.) or dementia * Serum intact parathyroid hormone(iPTH)\>250 pmol/L within 30 days prior to screening visit * Dysrhythmia or severe cardiac disease, such as congestive heart failure (CHF) Class III-IV, or unstable cardiovascular disease within 90 days prior to recruitment * Severe peripheral arterial disease * Severe hyperkalemia (\>6.5 milliequivalent/L) consistently the last 2 weeks * Current active cancer (excluding basal cell carcinoma of the skin) * Poorly controlled hypertension (post-dialytic systolic blood pressure ≥ 160mmHg or diastolic blood pressure≥ 100 mmHg) within 4 weeks prior to recruitment * Anticipated living donor kidney transplant or any other planned major surgery over the study duration * History of poor treatment adherence