Inclusion Criteria:  Moderate-severe CKD determined by eGFR <60ml/min per 1.73m2 by CKD EPI equation on at least 2 consecutive occasions. Metabolic acidosis defined as bicarbonate level<23 on two consecutive occasions. Age 30 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.