Safety, Feasibility and Efficacy of Sulforaphane (Avmacol Extra Strength) in Chronic Kidney Disease

- 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

- 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.