This session will explore dialysis management in advanced heart failure (HF) amid the flurry of innovation in heart support. HF treatment options, indications, evidence, and outcomes will be reviewed. Ventricular assist devices will be addressed as they impact kidney function and require changes to standard dialysis nursing care. Hemodialysis and peritoneal dialysis in combination with advanced heart therapies will be discussed, including nursing implications, prescription adjustments, and access choice. Finally, education recommendations for facilities and providers will be reviewed.