the purpose of this study is to compare between intradialytic aerobic versus resistive exercises on immunity response in patients with chronic kidney disease.

The patients of this study will randomly assigned into three equal groups (n=20)

1. Study Group A (20 patients) will receive intradialytic aerobic exercise and medical treatment.
2. Study Group B (20 patients) will receive intradialytic resistive exercise and medical treatment.
3. Control Group C (20 patients) will receive medical treatment only (HD session and drugs) Each patient will receive the treatment program three times per week for three months.

Inclusion Criteria:

• Sixty men chronic kidney disease (grade III RF). They received regular hemodialysis sessions at least one year ago, each one for four hours, three times per week.
• They had a history of type II Diabetes more than five years.
• Their age will be ranged from 50-60 years old.
• They are Fit for exercise by functional assessment using six minute walk test.
• Their Hemoglobin level more than 10 g\dl.
• Their Body Mass Index (BMI) will be ranged from "18.5" to "24.9".

Exclusion Criteria:

• Severe cardiac disorders.
• Severe orthopedic problems (for example fractures).
• Hepatic encephalopathy.
• Preexisting neuromuscular diseases (e.g. myasthenia gravis). •Severe chest diseases.
• Spinal cord injuries involved the phrenic nerve.
• Uncontrolled diabetes or hypertension
• Patients receiving inefficient hemodialysis session.
• Patients with other cause for inflammation e.g. malignancy and autoimmune disease.
• Active bleeding as alveolar hemorrhage, hemoptysis.
• Physical limitation that would limit cycling.