<![CDATA[Chronic Kidney Disease (CKD) is a global health problem requiring long-term renal replacement therapy, including hemodialysis. Although hemodialysis is essential for survival, patients often experience fatigue, which negatively impacts functional capacity, daily activities, and quality of life. One non-pharmacological approach to reducing fatigue is intradialytic exercise, defined as physical activity performed during hemodialysis sessions. This systematic review aimed to evaluate the effectiveness of intradialytic exercise in reducing fatigue levels in patients with chronic kidney disease undergoing hemodialysis. The systematic review was conducted using the PICO framework. Articles published between 2020 and 2025 were identified from PubMed, ScienceDirect, and Google Scholar databases. A total of 137 articles were retrieved, and inclusion criteria were selected using full-text studies with quasi-experimental designs, randomized controlled trials, or pre-experimental studies examining intradialytic exercise and fatigue outcomes in hemodialysis patients. Study selection followed PRISMA guidelines, and data were extracted based on study design, sample size, intervention type, and outcomes. Therefore, ten articles that met the inclusion criteria were used. Findings consistently demonstrate that intradialytic exercise, including flexibility, aerobic, resistance, and stretching exercises, significantly reduces fatigue levels in patients undergoing hemodialysis. Several studies also report improvements in activity tolerance and dialysis adequacy. Intradialytic exercise is an effective and safe non-pharmacological nursing intervention to reduce fatigue in CKD patients undergoing hemodialysis. Integrating intradialytic exercise into routine hemodialysis care can improve patient well-being and quality of life.]]>
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