Patients with advanced kidney disease often experience frailty and muscle loss, increasing their health risks. While exercise is recommended to improve muscle strength and physical function, we think combining exercise training and dietary supplement (CoQ10) could further enhance muscle function and physical abilities. By understanding how CoQ10 and exercise interact, we hope to find new ways to make exercise more effective and prevent frailty and muscle loss in these patients.

Muscle and its function declines with worsening kidney function. Acid buildup in the body as a result off poor kidney function can cause muscle weakness and fatigue. We are studying how treatment of acid buildup in the body of patients with kidney disease can improve metabolism (the supply of energy), fatigue and the function of muscles, and improve the body's response to insulin. Our goal is to discover if being treated with sodium bicarbonate lowers acid in the body, improves the ability of muscle tissue to create energy from nutrients, improve the body's response to insulin, and improve exercise tolerance. Participation in this study involves two separate treatment periods (sodium bicarbonate or placebo) totaling up to 12 visits. Each treatment lasts for a duration of 16 weeks.