Heart failure (HF) is highly prevalent in patients with end-stage kidney disease (ESKD),1 and is associated with poor outcomes. Despite the high burden and consequences of HF in patients treated with dialysis, key gaps remain that limit optimal care of patients with HF and concomitant ESKD. There are few contemporary studies of HF incidence and existing studies have relied on administrative codes, which may contribute to misclassification of HF.2,3 Further, although there is greater recognition that HF subtypes (reduced [HFrEF] versus preserved [HFpEF] ejection fraction) may have distinct mechanisms and treatment approaches, there are limited data on the incidence of HF subtypes in ESKD patients.