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In patients with chronic kidney disease (CKD) and heart failure (HF), volume overload is a major problem. Removal of fluid during the dialysis treatment is the cornerstone management in these conditions, but assessing the amount of volume that should be removed is a challenge since physical exam findings are not accurate. Ambulatory pulmonary artery (PA) pressure measurement is a promising tool in HF that potentially could be used as well in CKD population, monitoring volume status changes and allowing a prompt intervention such as increasing or decreasing the volume of ultrafiltration. We presented two cases of patients with CKD, HF and CardioMEMS.