Inclusion Criteria:  Adults > or equal to 18 years old (no upper age limit); who are > 3 months after starting maintenance hemodialysis No expected change in dialysis modality, elective surgery or relocation outside of study site during the intervention period (16 weeks) Assessed to be safe and able to exercise by the hemodialysis unit nephrologist Able to communicate in English and provide written informed consent  Exclusion Criteria:  Acute coronary syndrome in the past 3 months Unstable arrhythmia Shortness of breath at rest or with minimal activity (NYHA Class 4) Symptomatic hypoglycemia (>2x/week in week prior to enrolment) Participating in clinical intradialytic cycling program in last 6 months (if a clinical program exists)