A Study to Assess the Tolerability and Efficacy of AKST1210 in Patients on Hemodialysis With Cognitive Impairment

Inclusion Criteria: * On chronic hemodialysis due to end-stage renal disease for ≥ 12 months. * Score on the Montreal Cognitive Assessment (MoCA) ≥ 16 and ≤ 23. * Body mass index (BMI) ≥ 20 and ≤ 36. * The subject must be able to follow the study protocol, receive the treatment in the established timeframe, and continue during the follow-up interval. * The subject must have sufficient visual and auditory acuity to reliably complete all study assessments. * Provided a signed and dated informed consent form. Exclusion Criteria: * Subjects for whom adequate anticoagulation cannot be achieved. Use of antiplatelet drugs (e.g., aspirin or clopidogrel) is allowed. * History of hypersensitivity to heparin. * Pregnant or breast-feeding women or women who are planning to become pregnant. * Clinically significant abnormalities on Screening ECG including QT interval corrected for heart rate (QTc) (using Fridericia's correction formula) of ≥ 500 ms in men and ≥ 520 ms in women. * Clinically significant and unexpected abnormalities in this patient population in complete blood count, complete metabolic panel, coagulation, and thyroid stimulating hormone (TSH). * Subjects with a hemoglobin level \< 9.0 g/dL. * Concurrent or recent participation in another investigational clinical trial. Prior clinical trial subjects must have discontinued investigational agents at least 30 days prior to Screening. * Subjects planning to receive renal transplantation during the study. * Any other condition…