Clinical Research Directory

Inclusion Criteria: * Age ≥ 18 years and ≤ 80 years * Estimated glomerular filtration rate (eGFR) ≥ 20 and \< 60 mL/min/1.73m2 and a decline in eGFR of ≥ 3 ml/min/1.73m2 /year in the previous 12 ± 2 months * Able to provide consent * Able to swallow Avmacol ES or placebo capsules Exclusion Criteria: * Significant co-morbid conditions with life expectancy of \< 1 year * Serum potassium of \> 5.5 milliequivalents per liter (mEq/L) at screening * New York Heart Association Class 3 or 4 heart failure symptoms, known Ejection Fraction (EF) ≤ 30% or hospital admission for heart failure within the past 3 months * Factors judged to limit adherence to interventions based on appointment attendance and medication treatment compliance; PI will make this determination * Current participation in another medical intervention study * Known to be pregnant or planning to become pregnant or currently breastfeeding; determined by self-report and medical record history. A urine pregnancy test will be completed for individuals of childbearing potential before administering the study drug, and repeated thereafter at every study visit (\~ every 3-4 months) * History of dementia documented in the medical record * On anticoagulants or immunosuppression * Under treatment for cancer * Delayed gastric emptying or similar GI conditions Non-English-speaking individuals are excluded in this randomized phase of the study because the lack of English proficiency will affect a subject's ability to report problems or adverse events. If a patient cannot read, the consent form will be read to them by the research coordinator.