Mindfulness in Chronic Kidney Disease

Inclusion Criteria: * stages III and IV CKD as defined by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation * stable renal function (no greater than a decline of eGFR of 1 cc/min/1.73 m2 per month over the prior 3 months) Exclusion Criteria: * severe CKD (eGFR\<15 cc/min) * diabetic neuropathy * autonomic dysfunction * any serious disease that might influence survival * anemia with hemoglobin \<10 g/dL * treatment with central α-agonists or monoamine oxidase (MAO) inhibitors * myocardial infarction or cerebrovascular accident within the past 6 months * uncontrolled hypertension (BP≥170/100 mm Hg) * low BP (BP\<100/50 mm Hg) * bradycardia (HR\<55 beats/min) * ongoing drug or alcohol abuse (defined as \>2 drinks/day in men, and \>1 drink/day in women) * surgery within the past 3 months * adjustment of antihypertensive medications within the past month * pregnancy or plans to become pregnant * psychosis * suicidal ideation * implanted electronic or metallic device such as a pacemaker * implanted hearing aid, bone plate, carotid stent, bone screw at or near the neck * carotid atherosclerosis * concurrent use of another stimulating device such as a transcutaneous electrical nerve stimulation (TENS) unit