Stress and CKD Among African Americans

On Day 1, the project coordinator will explain the study to participants and answer any
questions he/she may have. Those who agree to participate in the study will provide consent
at the clinic and will also be asked to complete a questionnaire on an iPad in a small,
private room at the clinic. The participant will complete the questionnaire alone, however,
the project coordinator will read questions aloud if the participant chooses. Before leaving
on Day 1, participants will fitted with a blood pressure monitor to be worn for the next 24
hours.

The clinical intervention portion of the study occurs during the morning of Day 2 (between
9:00 AM and 11:00 AM). Participants will be instructed to bring the blood pressure monitor
and a list of current medications (or the actual medications) with them. First, participants
will provide a urine sample and undergo blood pressure testing. A research nurse will insert
a catheter (a small thin tube) into the participant's vein, and allow a 30-minute resting
period so that the participant gets used to the catheter, and then take a baseline blood
draw. Participants will judge how distressed they feel in that moment using a standard scale
and tell the project coordinator his/her rating. Next, participants will be asked to recall
two stressful experiences - one related to race and the other not related to race.
Participants will be randomized to the order that they tell these stories. An audience of two
observers of same race will wear white coats and watch as the participants recall the
stressful events. The research nurse will draw blood and take blood pressure measurements at
multiple time points during both recall experiences. Immediately before and after each recall
task, the participant will again judge how distressed he/she is feeling in that moment using
the same scale as before. The project coordinator will explain the purpose of the story
recall and common ways that individuals may respond to the task (such as feeling anxious
after the task). A total of 100 people will take part in this study.

Inclusion Criteria:

- Patient at Emory University Hospital Midtown

- Self-identify as African American or Black

- Estimated glomerular filtration rate (eGFR) ≥ 15, or <90

Exclusion Criteria:

- Mental disorder that prevents the completion of the Computer Assisted Personal
Interview (CAPI) and the stressful recall manipulation

- Currently on maintenance dialysis

- Unable or unwilling to undergo intravenous catheterization