In line to determine efficacy of virtual reality versus intradialytic neuromuscular electrical stimulation on renin hormone levels in patients with chronic kidney disease, a 60-patients of both genders with chronic kidney disease whom undergoing hemodialysis three times per week their age (50-60y) were randomly allocated into two groups. Group A received Virtual reality, plus conventional physical therapy protocol, Group B received intradialytic neuromuscular electrical stimulation protocol; 3 session per week. Group C received Conventional Physical Therapy protocol. Treatment protocol extended for eight weeks, where evaluation involving renin hormone test, upper extremity musculature strength using dynamometer, kidney glomerular filtration rate.