Abstract: Chronic kidney disease （CKD） is associated with an elevated risk of cardiovascular disease, particularly in the form of heart failure （HF）. HF with concurrent CKD is quite common and it is associated frequently with a poor prognosis. The unique pathophysiological mechanisms of CKD may explain a large difference in mortality between patients with CKD plus HF and those with cardiovascular disease alone. While strong evidence has been established for managing HF patients, no guideline recommendation based upon a high level of clinical evidence is available for dealing with patients with CKD plus HF. This review summarized the diagnostic and therapeutic rationales for managing CKD plus HF.