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.

If you are living with Chronic Kidney Disease, you may be experiencing a common problem - loss of muscle mass and strength - which impacts your daily living activities. We hope to better understand the effect of exercise on energy production in people with kidney disease. This knowledge may help to improve your ability to be active and independent. The purpose of this research study is to find out if a supervised home exercise program developed at UC Davis might improve how well your kidneys work. We also want to know if exercise improves the ability to perform physical tasks. We will enroll 40 participants with Chronic Kidney Disease to take part in this study. Participants will be placed by random assignment to receive either the study exercise program or your usual care without the exercise program. You will have a 75% chance of being in the exercise group, and a 25% chance of being in the no-exercise group. The no- exercise group will receive free fitness testing and consultations. At the end of the study, we will compare muscle metabolism and muscle function in those who were and were not assigned to the exercise program.

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.