Introduction <p>Chronic kidney disease (CKD) is a global health concern, often diagnosed late, particularly in India. Hemodialysis (HD), the most common treatment, impacts quality of life and can lead to impaired respiratory functions. Spirometry parameters (FVC, FEV₁) assess lung function, while MIP and MEP measure respiratory muscle strength. Monitoring these is crucial in CKD patients on hemodialysis to prevent respiratory complications. This study evaluates the effect of nurse-led respiratory muscle training on functional capacity and respiratory muscle strength in hemodialysis patients nephrology unit of the tertiary care centre of western Rajasthan.</p> Methodology <p>A quasi-experimental, non-equivalent control group pre-test post-test study was conducted in the nephrology unit of the tertiary care centre of western Rajasthan. A total of 86 hemodialysis patients (43 control, 43 experimental) were selected using non-probability consecutive sampling. The experimental group underwent a nurse-led respiratory muscle training (RMT) program for 8 weeks whereas control group received conventional care. Respiratory muscle strength was assessed using MIP, MEP, and the breath-hold test, while functional capacity was measured using pulmonary function tests (PFT) and the six-minute walk test (6MWT).</p> Results <p>After eight weeks of nurse-led respiratory muscle training, the experimental group showed significant improvements in maximal inspiratory pressure (67.1 ± 11.27 to 80.9 ± 11.4 cmH₂O, (p &lt; 0.001), maximal expiratory pressure (93.2 ± 12.8 to 105.9 ± 13.2 cmH₂O, p &lt; 0.001), FVC (2.7 ± 0.4 to 3.0 ± 0.3 L, p &lt; 0.001), and FEV (2.1 ± 0.3 to 2.4 ± 0.3 L, p &lt; 0.001). The control group showed minimal changes (p &gt; 0.05).</p> Conclusion <p>Nurse-led respiratory muscle training significantly enhances respiratory muscle strength and lung function in hemodialysis patients, supporting its integration into CKD care.</p>