Interleukin-1 Blockade for the Treatment of Heart Failure in Patients With Advanced Chronic Kidney Disease

Inclusion Criteria: * Written informed consent * 18 years or older * Chronic heart failure * Left ventricular ejection fraction less than 50% * C-reactive protein greater than or equal to 2 mg/L * Maintenance hemodialysis with a biocompatible membrane, acceptable dialysis adequacy (Kt/V \> 1.2), and receipt of a stable hemodialysis prescription for at least 4 weeks OR chronic kidney disease stage IV/V (estimated glomerular filtration rate \<30 mL/min/1.73m2) Exclusion Criteria: * Inability to complete maximal cardiopulmonary exercise testing * Need for urgent or emergent care * Recent use of immunosuppressant, anti-inflammatory therapies or active rheumatologic disease * Allergy to rubber, latex, Escherichia coli or anakinra