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PLEASE READ BELOW BEFORE FILLING OUT THIS FORM:

Thank you for interest in our study! This research study is designed to determine the health effects of daily consumption of beetroot juice (~1/3rd cup/day) in people (ages 30-80) with chronic kidney disease. If you have not received a diagnosis of chronic kidney disease from your healthcare provider, you may still be eligible to participate in the study if your blood and urine tests suggest that you have reduced kidney function. However, the study team will not be able to diagnose you with chronic kidney disease. Also, your participation in the study does not mean that you have chronic kidney disease.

This study involves 16 visits and an optional follow-up visit. The total time commitment is about 26 hours spread over 3-5 months. Each visit will take between 0.5 and 3.5 hours. More information about the study can be found on the study description pages included in the materials sent to you.

If you have any questions you can contact the Integrative Physiology of Aging Lab at (303) 735-6410 and beetrootstudy@colorado.edu

You will Receive:
Taking part in the study includes gaining information about your health from the many tests that are done including information about your blood sugar, cholesterol, some hormones, exercise capacity and heart health. Along with the health information you will receive money in a form of a check if you complete the study. If you decide not to complete the entire study, you will be compensated for the tests you complete.

COVID-19 and Our Research: Our lab has taken numerous measures to ensure the safety of our subjects and staff during this time in accordance with facility (Clinical Translational Research Center, CTRC) guidelines. This includes: social distancing when possible, requiring masks to be worn while in our facility,
thoroughly sanitizing equipment subjects and staff come in contact with, and requiring subjects to answer COVID-19 screening questions before coming in to the CTRC.

These measures may evolve to be in line with guidance from the CTRC medical director.

Instructions:
Once you begin the survey, it will take ~15 minutes of your time. You CANNOT save your answers and continue at another time.

After you complete the form, a member of our research team will review your responses and contact you regarding your participation. If you qualify and are interested in the study, you will be asked to come to the University of Colorado Boulder campus to get more information about this study.

You will also be asked to refrain from food, caffeine, strenuous exercise and alcohol when you come in for your first study visit because these things can also interfere with the measurements we will be making, such as your blood pressure. You must refrain from food and caffeine for 12 hours. You must refrain from strenuous exercise and alcohol for 24 hours.

Your answers to the questions on this screening form will be used to determine whether you qualify for participation in our research study. Your responses are confidential and will only be used for research purposes.

Participation in this pre-screening is voluntary. If you agree to participate in this
pre-screening please continue filling out the survey below.

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