Persons with CKD are at risk for left ventricular dysfunction. Durable LVADs are used for advanced heart failure not manageable with conservative therapies. Lower preimplantation kidney function is associated with worse outcomes.1 An American Heart Association statement on mechanical circulatory support stated that patients receiving long-term dialysis should not be considered for durable support.2 Among Medicare beneficiaries receiving external or internal LVADs, ESRD is associated with 36-fold higher mortality.