Chronic kidney disease (CKD) affects more than 26 million individuals (13 percent) of the U.S. population, with a projected 70 percent increase by the year 2015 to over 40 million individuals. Impairments in physical function and mobility limitations have been reported in older Chronic Kidney Disease patients, however the consequences of impaired functioning on participation in daily life and quality of life have not been studied. Early identification and interventions to mitigate deterioration in physical function and mobility should lead to improved health and quality of life outcomes in older patients with Chronic Kidney Disease. Although older individuals with Chronic Kidney Disease have reduced survival expectancy, maintaining physical function and mobility may contribute to longer active life expectancy, and higher quality of life despite their diagnosis.

Inclusion Criteria:

• Male and female patients over the age of 60 years
• Diagnosed with moderate to severe CKD (stage 2-4)
• Ambulatory (with or without use of an assistive device such as a cane or walker)
• Living in the community, cognitively able to provide consent and understand directions for the tests
• Cognitive ability to understand and carry out an independent home walking program
• Access and ability to communicate with study staff on a weekly basis and available for follow-up testing.

Exclusion Criteria:

• Inability to carry out a program of walking independently at home
• Unavailable for follow-up testing, estimated GFR >60 ml/minx1.73m2 and < 15 ml/minx1.73 m2
• Recent cardiac event (within the past 6 months)
• Uncontrolled hypertension
• Uncontrolled diabetes
• Pulmonary disease that may limit the ability to progress with walking
• Progressive neuromuscular disease
• Any orthopedic or neuromuscular condition that may be exacerbated by increased walking activity
• diabetic foot ulcer.