Inclusion Criteria:

• Adults aged 18 and over, undergoing chronic hemodialysis at CHI André Grégoire for more than 3 months.
• Consent to participate in physical activity during dialysis sessions.
• Written informed consent.
• Affiliation with a social security system

Exclusion Criteria:

• Lower limb amputation without a prosthesis.
• Non-healed foot wounds.
• Hemoglobin < 8 g/dl.
• Patient refusal to participate.
• Severe respiratory (oxygen dependence) or cardiac disease (NYHA class 3 or 4, LVEF < 30%).
• Advanced dementia or psychiatric illness impeding cooperation, or refusal to consent.
• Non-French speaking patients unable to understand the study.
• Patients under guardianship.
• Advanced osteoarthritis, recent hip or knee prosthesis (< 3 months).
• Hypotension (BP < 90/40 mmHg) or hypertension (BP > 180/110 mmHg).
• Fever (temperature >= 38°C).
• Hypoglycemia (fingerstick glucose < 0.8 g/l) in diabetic patients.
• Dyspnea or desaturation in ambient air < 95%.
• COVID-19 symptoms within the last 21 days, positive PCR test, unable to pedal.
• Chest pain or unstable angina.
• Muscle or joint contraindications to the pedal exerciser as assessed by a physiotherapist