This randomized controlled trial aims to evaluate the effectiveness of a nurse-led integrated nutrition and exercise intervention on improving health-related quality of life among hemodialysis patients. Patients undergoing maintenance hemodialysis often experience reduced quality of life due to physical, psychological, and dietary challenges.

In this study, participants are randomly assigned to either an intervention group receiving a structured nurse-led program that includes individualized nutritional counseling and supervised exercise sessions, or a control group receiving usual hemodialysis care. The intervention is designed to enhance patients' physical function, nutritional status, and overall well-being.

The primary outcome is the change in quality of life measured using a validated instrument over a defined follow-up period. The findings of this study may provide evidence for the integration of nurse-led lifestyle interventions into routine hemodialysis care to improve patient outcomes

Hemodialysis patients commonly experience multiple physical, psychological, and social challenges that negatively affect their quality of life. These challenges include fatigue, reduced physical activity, dietary restrictions, and comorbid conditions. Despite advances in dialysis care, improving quality of life remains a key clinical priority.

This study is a multi-center, parallel-group randomized controlled trial conducted to assess the effectiveness of a nurse-led integrated nutrition and exercise intervention among patients undergoing maintenance hemodialysis. A total of 120 participants were enrolled and randomly allocated into two groups: an intervention group and a control group.

The intervention group received a structured program delivered by trained nurses, which included individualized nutritional counseling based on dialysis-specific dietary recommendations and a supervised exercise regimen tailored to patient tolerance and clinical condition. The program aimed to improve dietary adherence, enhance physical activity, and promote overall health.

The control group received routine hemodialysis care without additional structured intervention.

The primary outcome measure was the change in health-related quality of life assessed using the Kidney Disease Quality of Life-36 (KDQOL-36) questionnaire. Secondary outcomes included changes in nutritional status, physical activity levels, and selected clinical parameters.

Data were collected at baseline and after the intervention period, and appropriate statistical analyses were conducted to compare outcomes between groups.

This study aims to provide evidence on the role of nurse-led interventions in improving the quality of life of hemodialysis patients and to support the integration of holistic care approaches into routine clinical practice.

Inclusion Criteria:

- Participants were included if they met the following criteria: Age ≥ 18 years, of either sex; Receiving maintenance hemodialysis for ≥ 6 months; Regular attendance at the dialysis center ; and Willingness to participate and provide informed consent.

Exclusion Criteria:

• The patients were excluded if they: Refused to participate in the study, and had other chronic diseases that could interfere with the study outcomes

Individual participant data will not be shared due to patient confidentiality and privacy considerations. The dataset includes sensitive clinical information of hemodialysis patients, and sharing IPD may pose risks to patient privacy. Only aggregated and de-identified results will be reported in publications and presentations

No masking is applied. Both participants and investigators are aware of group assignments due to the nature of the behavioral intervention