Chronic Kidney Disease (CKD) is a progressive condition that often leads to end-stage renal disease, requiring dialysis. Patients undergoing hemodialysis frequently experience physical inactivity and electrolyte imbalances, which can adversely affect their health outcomes. Regular physical activity is crucial for maintaining muscle strength and physical function in CKD patients.Electrolytes play vital roles in various physiological functions, including muscle contraction, nerve transmission, and fluid balance. In end stage renal disease patients, imbalances can lead to serious complications, including: hyperkalemia, Hyponatremia, and hypocalcemia.VR has been employed in medicine to assist patients in recovering their motor and cognitive abilities. It has proven effective in enhancing physical functions such as posture, balance, and motor skills. When combined with physical exercise, VR has been shown to improve the functional abilities and quality of life of hemodialysis patients. For those with end stage renal disease patients, who experience discomfort during hemodialysis, VR offers a distraction that can reduce the perception of pain, fatigue, nausea, lightheadedness, and headaches, thereby facilitating smoother exercise continuity and enhancing overall adherence to rehabilitation activities. so this study will be conducted to assess the effect of Intra-Dialysis Virtual Reality Exercise on Selected Electrolytes Balance in Patients with End Stage Renal Disease
