The Pristine Post-Market Study

Inclusion Criteria: 1. The participant or legally designated representative must voluntarily sign and date the approved Informed Consent Form (ICF) prior to collection of study-specific data or performance of study-specific procedures. 2. The participant must be willing and able to comply with protocol requirements, including all study visits and procedures. 3. The participant must be either a male or non-pregnant female ≥18 years of age. 4. The participant must have a diagnosis of End Stage Renal Disease with indication for a tunneled dialysis catheter creation. 5. Participant must require chronic hemodialysis treatments 3 times per week with intended use of the Pristine™ Long-Term Hemodialysis Catheter. 6. The participant meets the indications for hemodialysis use and does not meet any of the contraindications per the Pristine Instructions for Use (IFU). 7. The participant must have a patent jugular vein or subclavian vein. Exclusion Criteria: 1. The participant has known central venous stenosis 2. Based on the local primary investigator's discretion, the patient would not be an appropriate study candidate. 3. The participant has already undergone an AVF or AVG procedure and is awaiting maturation. 4. The participant has an active infection at the time of study enrollment. 5. The participant has a presence of bacteremia or infection within 7 days prior to enrollment. 6. The participant has a history neutropenia or a history of severe immunodeficiency disease. 7. The participant has uncontrolled abnormal coagulation parameters and are at additional risk for clotting or excessive bleeding at time of enrollment per physicians opinion. 8. The participant has a known allergy, intolerance or sensitivity to heparin, or previous incidence of heparin-induced thrombocytopenia. 9. The participant has a known allergy or hypersensitivity to any of the device materials or Ethylene oxide (EtO). 10. The participant has another medical condition or treatment, which in the opinion of the investigator, the participant may be non-compliant with the protocol, confound the data interpretation, or is associated with a life expectancy insufficient to allow for completion of study procedures and follow-up. 11. The participant is currently participating in an investigational drug or another device study that has not completed the study treatment or that clinically interferes with the study endpoints. Note: Studies requiring extended follow-up visits for products that were investigational but have since become commercially available, are not considered investigational studies.