Heart failure admissions are driven by elevated cardiac filling pressures culminating in symptoms of congestion and result in a significant burden to both patients and society. Traditional strategies of monitoring changes in weight and symptoms to trigger adjustments in therapy, even when combined with telemedicine services, have failed to improve outcomes. Implantable hemodynamic monitors allow clinicians to obtain meaningful, objective data, with an opportunity for early intervention to improve outcomes. Patients with concomitant kidney disease represent a particularly vulnerable population with higher rates of hospitalization compared with patients with heart failure and normal kidney function. Several studies have demonstrated a reduction in hospitalization rates with the use of ambulatory hemodynamic monitors. In the following review, we discuss the existing literature, including studies in patients with kidney disease, and highlight future innovations in the field.