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

A Randomized, Double-Blind, Phase 2a Study to Evaluate the Tolerability, Feasibility, and Efficacy of AKST1210 in Patients on Hemodialysis With Cognitive Impairment Associated With End-Stage Renal Disease

This study will evaluate the tolerability, feasibility, and efficacy of the AKST1210 column in subjects with end-stage renal disease with cognitive impairment (ESRD-CI) undergoing hemodialysis 3 times per week.

In this study, approximately 26 men and women on dialysis due to end stage renal disease and who have cognitive impairment will be randomly assigned to receive AKST1210 or control during each hemodialysis session for 3 months. The primary objective is to assess the safety and tolerability of AKST1210, and secondary objectives include changes in cognitive assessments as well as the feasibility of using AKST1210 in this setting.

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 and/or situation that the investigator believes may interfere with the safety of the subject, study conduct, or interpretation of study data.