Inclusion Criteria:
* Subjects able and willing to give Informed Consent and interested to participate in the study
* Subject aged 18 years or older
* Subjects meets one of the following three conditions:
* End stage renal disease (ESRD) patients who have been adequately treated with maintenance HD and deemed stable, according to the investigator, for at least three months
* Incident end stage renal disease (ESRD) patients who have been prescribed HD therapy
* Subjects on peritoneal dialysis who require conversion to hemodialysis, according to the investigator
* Subjects who have adequate access, capable of providing a blood flow rate of at least 300 mL/min
* Subject understands the nature of the procedures and the requirements of the study protocol
* Subject is willing and able to comply with the protocol requirements and return to the treatment center for all required treatments and clinical evaluations
Exclusion Criteria:
* Subjects with baseline dry weight of ≤ 60 kg or ≥ 110 kg
* Subjects with a documented history of non-compliance to scheduled hemodialysis sessions or clinic visits
* Subjects who are pre-scheduled for a living kidney transplant within the next two months, who plan a change to peritoneal dialysis (PD) within the next two months or who require single needle dialysis therapy
* Subjects with unstable electrolytes or acid base balance, in the opinion of the investigator
* Subjects with any major surgery or major adverse cardiac event within 3 months of screening
* Subjects with hemodynamic instability, defined as repeated hypo/hypertension, in the past 30 days from screening
* Subjects with active or ongoing infection, in the opinion of the Investigator
* Subjects with known Hepatitis B, C or HIV infection
* Subject with documented coagulation disorders, active or bleeding risk or who is intolerant to heparin
* Subjects who are currently participating or have previously participated in another interventional clinical trial in the past 4 weeks from screening
* Subjects with any comorbidities possibly conflicting with the study purpose or procedures, in the opinion of the Investigator
* Subjects who are pregnant or lactating or any patient with a childbearing potential who refuses to use medically acceptable means of contraception
* Subjects with an active, malignant disease and whose life expectancy is \< 6 months, in the opinion of the investigator
* Subjects with a hemoglobin \< 9 gm/dl in the past 30 days from screening
* Subjects with significant intradialytic hypotension in 30 days from screening
* Subjects with shock within 30 days from screening
* Subjects with active seizures in the last 6 months from screening
* Subjects with history of hemolytic anemia or thrombocytopenia
* Subjects with vascular access dysfunction (switching ports (reverse lines or catheter replacement) in 30 days prior to screening, multiple tPA (tissue plasminogen activator) administrations) or patient who has had a thrombectomy procedure within 30 days prior to screening
* Subjects with a documented history of congestive heart failure with symptoms consistent with NYHA Class III or IV, according to the investigator, or documented severe left ventricular dysfunction
* Subjects with fluid overload due to intractable ascites secondary to liver cirrhosis
* Subjects with active, life-threatening rheumatologic disease