Please select the eligibility criteria that correspond to the clinical trial below.
Title: Mindfulness for Symptom Reduction: A Transplant Candidate Study in Program Grant Studies of Organ Transplantation in Animals and Man 2P01 DK013083
Brief Summary: The purpose of this study is to determine whether telephone-adapted Mindfulness Based Stress Reduction (tMBSR) - a program of mindfulness meditation and gentle Hatha yoga delivered mostly by phone, is an effective program to reduce symptoms (anxiety, depression, sleep) and improve quality of life for people waiting for a kidney transplant. Participants will be randomly assigned to tMBSR or to a support group emphasizing communication skills and selecting resources. Both 8-week programs include an initial in-person meeting, 6 weekly teleconference calls, and conclude with an in-person meeting. Participants will complete questionnaires at 3 timepoints over 6 months, and if they receive a transplant, will complete additional questionnaires. Participants will complete sleep diaries and wear Actiwatches (similar to a wristwatch) for one week before programs start, and when programs end, to measure sleep. Participants will provide saliva samples, over 3 days before programs start, and again when programs end, to measure salivary cortisol, an indicator of stress. tMBSR participants will record daily home meditation practice.


Options:
A: Inclusion Criteria:

* On hemodialysis for 3 to 18 months and expected to remain on hemodialysis for at least two more years and with a life expectancy of a year or more
* Kidney transplant patients, whose transplant has failed, and now have been on hemodialysis for 3-18 months, may be eligible for the study, if they are not receiving excessive immunosuppression (e.g., \<=10 mg of steroids/day allowed)
* Pre-dialysis hemoglobin 8-12 g/dL, inclusive, within the previous month (single reading is sufficient)
* Stable hemodialysis vascular access, within the previous 3 months
* No heart disease or asymptomatic heart disease without enlarged heart

Exclusion Criteria:

* Heart diseases for which surgical intervention occurred during the previous two years or which may require intervention within the next year
* Patients with medical conditions likely to affect the response to epoetin
* Predialysis sitting diastolic blood pressure \>= 100 mmHg on average for the previous month
* Folate, Vitamin B12, or transferrin deficiency
* History of seizure within 1 year
* Transfusion within 30 days prior to study entry.
B: Inclusion Criteria:

* Undergoing thrice-weekly maintenance hemodialysis for ≥ 3 months
* Able to speak English
* ISI score ≥ 10 at pre-screening with sleep disturbances for ≥ 3 nights per week for ≥ 3 months

Exclusion Criteria:

* Severe cognitive impairment on Mini-COG cognitive test (score \< 3)
* Severe depression assessed by Patient Health Questionnaire (PHQ)-2 and if appropriate, PHQ-9
* Suicidal Ideation
* Alcohol abuse on CAGE alcohol assessment questionnaire (score ≥ 2) or substance abuse on Drug Abuse Screening Test (DAST)-10 questionnaire (score \> 5)
* Severe restless leg syndrome
* Treatment with trazodone in the past one month
* Known allergy to trazodone (self-report or by chart review)
* Current treatment with monoamine oxidase inhibitors or in the preceding 14 days
* Current treatment with linezolid (self-report or by chart review)
* Current treatment with other drugs that are inhibitors of CYP3A4 (e.g., itraconazole, clarithromycin, voriconazole), or known to prolong QT interval including Class 1A antiarrhythmics (e.g., quinidine, procainamide) or Class 3 antiarrhythmics (e.g., amiodarone, sotalol), antipsychotic medications (ziprasidone, chlorpromazine, thioridazine), and quinolone antibiotics
* Pregnancy, or lactation, or women of childbearing potential not willing to use adequate birth control
* Life Expectancy \< 3 months
* Expected to receive a kidney transplant or transition to home dialysis (peritoneal dialysis or home hemodialysis) within 6 months
* Any other condition that, in the opinion of the investigator, should preclude patient participation in the clinical trial
C: Inclusion Criteria:

* Candidate on the United Network for Organ Sharing (UNOS) wait list for a kidney or kidney-pancreas or evaluated as eligible for candidacy at the UMN
* Aged 18 or older
* English-speaking
* Literate
* Mentally intact
* Able to use the telephone to participate in 6 weekly teleconferences
* Able to attend 2 in-person classes in a Minnesota Metro area
* Able to comply with study monitoring requirements
* Receiving standard medical follow-up care
* Willing to complete the informed consent process

Exclusion Criteria:

* Prior transplant
* Medically unstable (a hospital admission for non-elective purposes in the last 3 months or major non-transplant surgery planned in the next 3 months)
* Serious preexisting mental health issues: suicidality or thought disorder/psychosis; or delirium or substance abuse
* Not expected to be on the waiting list \> 3 months (e.g., acceptable living donor has been identified and scheduled)
* Prior MBSR class or regularly practicing mindfulness meditation (twice a week or more)
* Not receiving standard medical care.
D: Inclusion Criteria:

Participants diagnosed with ESKD and undergoing haemodialysis for ≥ 3 months, aged 18 years and above, able to speak and understand Nepali language and willing to participate will be included in this study.

Exclusion Criteria:

Participants who are in the early stage of CKD or not dependent on HD, those acutely ill, diagnosed with cognitive impairment and those who are not willing to participate will be excluded.

Answer: C