Inclusion Criteria:  Current diagnosis of ESRD. Receiving hemodialysis ≥3 times per week with each hemodialysis session being a minimum of 3 hours duration via a normally functioning, uninfected AVG for at least 4 weeks. A female participant is not pregnant or breastfeeding, not a woman of child-bearing potential (WOCBP) or is a WOCBP and agrees to follow contraceptive guidance during the intervention period and for at least 90 days after the last dose of study intervention.  Exclusion Criteria:  Recent history of cancer (<1 year). Non-melanoma skin cancers are allowed. Mechanical/prosthetic heart valve. Recent hemorrhagic stroke or lacunar stroke (<1 month). Recent evidence (<1 month) of bleeding requiring hospitalization or unplanned medical attention, a history (≤2 years) of recurrent bleeding episodes including epistaxis, gastrointestinal (GI) bleeds or genitourinary (GU) bleeds requiring medical treatment or events requiring treatment with blood products. Recent history (<1 year) of drug or alcohol abuse or dependence. Currently receiving or planning to receive anticoagulants or antiplatelet medications. Planning on receiving a living donor renal transplant within 12 months (participants are permitted to be candidates for deceased donor renal transplants). Planning on receiving an arteriovenous fistula (AVF) placement within 12 months.