Evaluate the Impact of Targeted Physical Activity on Clinically Debilitated Dialysis Patients.

This study is evaluating whether a targeted physical activity program can improve strength, fitness, and quality of life for people with kidney disease who are physically weakened — including those on dialysis or with advanced CKD. **You may be eligible if...** - You are on dialysis, OR have stage 4 CKD (GFR 15–29), OR have stage 5 CKD (GFR below 15), OR have had a kidney transplant (for a specific subgroup) - Your healthcare provider has described you as clinically debilitated (physically weakened) - You are able to understand questionnaires and follow instructions **You may NOT be eligible if...** - You have heart or lung disease that makes physical training unsafe - You are unable to provide consent - You are unable to travel to the training center Talk to your doctor to see if this trial is right for you.