Objective To analyze the current hotspots and future directions of exercise research in dialysis patients, and to provide reference for further studies. Methods Publications related to exercise in dialysis patients were searched in the Web of Science Core Collection and the China National Knowledge Infrastructure (CNKI) from January 1, 2004 to September 1, 2024. CiteSpace software was used to visually analyze the information of the selected articles. Results A total of 951 Chinese articles and 867 English articles were included. The number of publications on exercise research in dialysis patients showed increasing trend. The high-frequency keywords included "quality of life", "nursing", "aerobic exercise" ,etc. A total of 19 keyword clusters were identified in Chinese publications and 16 keyword clusters in English publications. The timeline and time zone diagrams of keywords showed that studies on Chinese traditional exercise, evidence-based nursing and use of virtual reality technology in dialysis patients were increased. The most recent burst keywords were "sarcopenia", "autologous arteriovenous fistula", "fatigue", etc. Conclusion Exercise in dialysis patients needs further in-depth studies. Current research hotspots focus on health-related quality of life, application of emerging technologies, and optimization of nursing strategies. The future research directions include patients comorbid with sarcopenia, symptom management, and the development of evidence-based exercise programs.