Hemodialysis patients experience a variety of complications one of the complications is respiratory system disorder.The incentive spirometer can help hemodialysis patients to improve their respiratory status. the main goal of this research is determine the effect of Incentive spirometry on pulmonary ventilation of hemodialysis patients. and sub goals is : 1.Determine and compare the FVC, FEV1, FEV1/FVC before the study, in the intervention and control groups. 2. Determine and compare the FVC, FEV1, FEV1/FVC month after the intervention, in the intervention and control groups. 3. Determine and compare the FVC, FEV1, FEV1/FVC, two months after the intervention,in the intervention and control groups. 4. Comparison of FVC, FEV1, FEV1/FVC before the study, one month and two months after in the intervention group 5. Comparison of FVC, FEV1, FEV1/FVC before the study, one month and two months after the intervention in the control group 6. Determine and compare the average distance over 6 minutes walk before, one month and two months after in the intervention and control groups Participants must be at least 6 months of hemodialysis treatment. Inclusion criteria: completely satisfactory cooperation; ability to perform spirometry; normal chest and spine according to the patient stated; minimum age 18 years; hemodialysis three times a week; hemodialysis for at least 6 months; no history of chronic lung disease; absence of valvular heart disease; CHF; cardiac arrhythmia; high blood pressure of 100/180 and lower than 60/100. Exclusion criteria: severe disability; the patient's unwillingness to cooperate; cardiac surgery or chest area Lung volumes and the distance in 6 minutes walking measured initially in the participants, and then use of incentive spirometry applies for two months as intervention. One and two months after the intervention indicators are measured and compared with before the intervention. Expected to improve lung volumes.