Exercise and Cardiac Stunning During HD

Inclusion Criteria: * Adults greater than or equal to 18 years old (no upper age limit); who are greater than; 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 * Must be dialyzing thrice weekly 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 3 months (if a clinical program exists)