This study aims at evaluating, in chronic kidney disease patients on dialysis, the effect of acute per- or pre-dialytic physical exercise on regional myocardial function and myocardial stunning, blood viscosity, arterial stiffness, variability of sinus rhythm, dialysis efficacy, inflammation, mineral and bone disorders, myokines and cardiac remodeling markers.

Inclusion Criteria:

• Patient aged ≥ 20 to ≤ 79 years
• Undernourished patient according to the ARNOS score : ≥ 2
• No medical contraindication to physical activity
• Life expectancy greater than 6 months
• Patient on hemodialysis for more than 3 months
• Patients with relatively good echogenicity

Exclusion Criteria:

• Patient is participating in another Category I interventional study, or has participated in another interventional study within the past 3 months
• The patient is in an exclusion period determined by a previous study
• The patient is under legal protection or under guardianship or curatorship
• It turns out to be impossible to give the patient informed information, or the patient refuses to sign the consent
• Pregnant, parturient or breastfeeding patient
• Patient with a contraindication to retraining
• Patient with valvular heart disease, arteriopathy of the lower limbs stage III and IV, amputation or knee or hip prosthesis
• Patient with musculoskeletal problems
• Patient with severe respiratory failure
• Paired sleep apnea syndrome
• BMI> 35
• Patient with automatic implantable defibrillator
• Heart transplant
• Uncontrolled high blood pressure
• Ejection fraction <45%
• Unstabilized coronaries
• Non-contributory stress ultrasound