Overview

The purpose of this pilot interventional study is to collect preliminary data on the application of a transcutaneous auricular vagal nerve stimulation (taVNS) device in patients with chronic kidney disease (CKD). This data will enhance understanding of the short-term safety, tolerability and effects of this novel therapeutic approach in the setting of CKD. The primary aims are to investigate the feasibility of the protocol and generate preliminary signals of efficacy and tolerability for two different doses of vagal nerve stimulation. The pilot estimates will be used to design a larger scale study that may lead to potentially targeted interventions to reduce cardiovascular (CV) mortality in the CKD population.

Eligibility

Inclusion Criteria:

        • Individual 18-80 years of age with CKD stage 3-5 (eGFR <60 mL/min/1.73m2) on most recent
        outpatient labs.
        Exclusion Criteria:
          -  Pacemaker dependent
          -  Prisoners
          -  Pregnant women. A pregnancy test will be offered if a subject is concerned about being
             pregnant.
          -  Not capable of informed consent
          -  Know autonomic function disorder (e.g. Parkinson's disease with autonomic dysfunction)
          -  ICD or PPM precluding assessment of heart rate variability (e.g. chronic atrial
             fibrillation)
          -  Recent myocardial infarction (4 weeks or less)
          -  Maintenance dialysis
          -  Epilepsy
          -  Patients on labetalol (labetalol will interfere with catecholamine measurements)
          -  Patients with diabetes
          -  At least 50% of cohort must not be on beta blockers. This will help to distinguish the
             confounding effects of beta blockers.