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:

* receipt of primary care at a VISN 10 Northeast Ohio CBOC
* GFR (calculated according to the 4 variable Modification of Diet in Renal Disease study equation) less than 45 mL/min per 1.73m2 with a second GFR less than 60 at least 90 to 730 days prior to the index GFR (26); and
* at least one primary care visit in the year prior to study initiation.

Exclusion Criteria:

* ESRD as defined by chronic renal replacement therapy,
* receipt of a renal transplant,
* hospice care, and
* age greater than 85 years or less than 18 years at the time of study initiation.
B: Inclusion Criteria:

* enrolled in Kidney Function Program (KFP)
* previously received KFP-administered dialysis modality education
* personal access to a home computer (ie. either their own or a close friend/family member) with internet access
* most recent eGFR \< or = 20mL/min/1.73m2

Exclusion Criteria:

* inability to provide informed consent
* inability to use a home computer or internet
* inability to understand English (written or spoke)
* severe visual or auditory impairment
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:

* Patients with CKD (defined as estimated Glomerular Filtration Rate \< 60ml/min/1.73m2 or proteinuria consistently over 3 months) who speak English, Spanish or Cantonese and have a primary care provider

Exclusion Criteria:

* Kidney transplant recipients; pregnant women; individuals with an eGFR \<15 ml/min/1.73 m2; prevalent dementia; impaired cognition or severe mental illness; expected life expectancy \<6 months; no phone access; self-reported hearing impairment; severe visual impairment preventing use of a touch-tone telephone keypad; and non-study language

Answer: C