Description
Inclusion Criteria:
- * Moderate-severe CKD determined by eGFR \<50ml/min per 1.73m2 by CKD EPI equation on at least 2 consecutive occasions.
- * Metabolic acidosis defined as bicarbonate level\<24 on two consecutive occasions. Bicarbonate level of 24 or less allowed if eGFR\<=45ml/min per 1.73m2
- * Age 21 to 85 years old
Exclusion Criteria:
- * Type 2 diabetes managed with insulin treatment
- * Poorly controlled diabetes (HgbA1c\>10%)
- * History of persistent hyperkalemia (K\>5.4)
- * Chronic treatment with renal replacement therapy
- * History of aortic dissection or severe valvular heart disease
- * Exercise induced angina
- * Uncontrolled cardiac dysrhythmia
- * Oxygen dependent COPD
- * Symptomatic claudication
- * End stage liver disease
- * Mobility disability defined as inability to walk without human assistance
- * Dementia or psychosis
- * Patients who cannot consent
- * Active use of IV drugs
- * Non-english speaking
- * History of transplant
- * Implants that prohibit MRI measurements or trauma involving metal fragments
- * Pacemaker
- * Expectation to start dialysis during the course of study.
- * Any condition which in the judgement of the clinical investigator places the participant at risk from participation in the study.
Ages Eligible for Study:
21 Years to 85 Years (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
No