The changes are being made because additional funding has been awarded to look further at the same question in a slightly different patient population. The previously approved study enrolls individuals with chronic kidney disease (CKD) stages 3 and 4 (moderate to severe CKD). The proposed changes will include individuals with CKD 5 (end-stage kidney disease) undergoing maintenance hemodialysis (MD). Given the major differences in how these groups of patients receive care (clinic visits averaging every 3-6 months with occasional blood work and primarily oral medications arranged per provider discretion for those with CKD 3 and 4, versus dialysis unit treatments of 3-4 hours/3 times weekly, with monthly blood work and various oral and IV medications prescribed per protocols for those with CKD 5 on MD), it is important to assess the proposed questions in both distinct groups.