Background: Chronic kidney disease (CKD) is a progressive condition leading to metabolic and functional impairments, often requiring hemodialysis. Despite its life-sustaining role, hemodialysis contributes to muscle atrophy, fatigue, and reduced quality of life. Intradialytic exercise has emerged as a promising rehabilitation strategy to mitigate these effects.

Objective: To evaluate the impact of continuous intradialytic cycle ergometer training on the quality of life, respiratory function, and muscle trophism of patients with CKD undergoing hemodialysis.

Methods: A randomized, blinded, longitudinal clinical trial was conducted at Dr. Abelardo Santos Regional Hospital (Belém, Brazil) with 40 hemodialysis patients, divided into an intervention group (continuous exercise) and a control group. Participants in the intervention group performed intradialytic cycle ergometry for 30–40 minutes per session, three times weekly for four weeks. Outcomes included muscle thickness (ultrasound), respiratory strength (manovacuometry), and quality of life (KDQOL-SF™ questionnaire). Data were analyzed using ANOVA with significance set at p≤0.05.

Results: Exercise training significantly improved overall quality of life (p<0.001), emotional well-being, physical functioning, and social interaction. Maximum inspiratory pressure (MIP) increased significantly (p<0.001), indicating improved respiratory muscle strength. Although no significant hypertrophy of the triceps surae or diaphragm was observed, participants demonstrated improved endurance and functional capacity.

Conclusion: Continuous intradialytic exercise using a cycle ergometer enhances quality of life and respiratory strength in CKD patients on hemodialysis, supporting its inclusion in multidisciplinary treatment protocols.