Inclusion Criteria:  dialysis patients on renal replacement therapy with chronic hemodialysis duration of hemodialysis treatment for at least 3 months capable of independent walking and independent feeding  Exclusion Criteria:  the presence of chronic malignant or infectious disease uncontrolled arterial hypertension with an average of the last five pre-dialysis blood pressure values above 180/100 mm Hg, unstable angina pectoris or Canadian Cardiovascular Society class 2-4, heart failure New York Heart Association class 3 and 4, the presence of a psychotic illness or a mental disability, a condition with an amputated limb (more than 2 fingers on the lower limb and / or more than 2 fingers on the upper limb) any other condition that causes the clinical unstability of the patient (i.e. repetitive gastrointestinal hemorrhagies, liver cirrhosis with frequent exacerbations)