This pilot study determined whether it was feasible to implement a self-managed exercise and education program (Renal Rehab) in incident hemodialysis (HD) patients. This study also determined if Renal Rehab improved the functional status of incident HD patients to a greater extent than standard care (StanC). Ten patients were randomized to either StanC (n=5) or Renal Rehab (n=5) at baseline and were followed to three-months. Physical function was assessed using the Short Physical Performance Battery test (SPPB). Baseline data was not different between groups. Many challenges were faced and addressed during the course of the study. Ultimately, patients in StanC improved SPPB total score by 2 points; whereas Renal Rehab’s SPPB total score decreased by 1 point from baseline to three-months (p<0.05). These data suggest that recruiting incident hemodialysis patients is difficult and that Renal Rehab does not improve physical function in the incident HD population. This thesis provides specific recommendations to inform further studies.