Safety Study of Soluble Ferric Pyrophosphate (SFP) in Dialysate in Chronic Kidney Disease (CKD) Patients Receiving Chronic Hemodialysis

Parent Study: A Randomized, Double Blinded, Crossover Study, up to 6 weeks, 900 patients.

Extension Study (Addendum): Open Label, Uncontrolled Study, up to 53 weeks, 300 patients.

Parent Study, Double Blinded, Crossover:

Key Inclusion Criteria:

1. Adult ≥ 18 years of age.

2. Has chronic kidney disease (CKD) receiving maintenance hemodialysis (HD) (CKD-HD
subjects) and regularly undergoing 2 or more dialysis sessions per week.

3. Stable pre-dialysis Hgb ≥ 9.0 to ≤ 12.5 g/dL.

4. Stable pre-dialysis TSAT ≥ 15% to ≤ 45%.

5. Stable pre-dialysis ferritin ≥ 100 to ≤ 1200 µg/L (1200 ng/mL).

Key Exclusion Criteria:

1. Any previous exposure to SFP.

2. Therapy with intravenous, intramuscular or oral iron at any time between the
first/screening visit and the randomization visit, or anticipated requirement for
iron supplementation during the study period.

3. Non-tunneled vascular catheter for dialysis.

4. Scheduled for kidney transplant within the next 8 weeks.

5. Active infection requiring systemic antimicrobial or antifungal therapy within 2
weeks prior to screening, or during screening period prior to randomization.

6. Hospitalization within 1 month prior to screening (except for vascular access
surgery).

Extention Study (Addendum), Open Label:

Key Inclusion Criteria:

1. Participated in Study RMTI-SFP-6 and completed the follow-up/early term visit.

2. Hemoglobin ≤12.0 g/dL at screening.

3. TSAT ≤45% at screening. (Excursion of TSAT by ≤10% outside this range permitted only
if all other inclusion/exclusion criteria are met).

4. Serum ferritin ≤1000 µg/L at screening. (Excursion of ferritin by ≤10% outside this
range permitted only if all other inclusion/exclusion criteria are met).

Key Exclusion Criteria:

1. Had a serious adverse event attributable (i.e., probably, possibly, or definitely
related) to study drug or had an adverse event attributable to study drug that
necessitated premature withdrawal from the double-blind, placebo-controlled crossover
phase of the parent study RMTI-SFP-6.

2. Non-tunneled vascular catheter for dialysis.

3. Scheduled for kidney transplant within 12 weeks after entry into extension phase.

4. Active infection requiring systemic antimicrobial or antifungal therapy within 2
weeks prior to dosing.

5. Pregnancy or intention to become pregnant during the study.