Both cardiac and renal diseases commonly present in the same patient and have been associated with increased costs of care, complications, and mortality. Cardiorenal syndromes (CRS), describing the dynamic inter-relationship between heart and kidney malfunction have been defined in a recent consensus process by the Acute Dialysis Quality Initiative (ADQI) .The primary term CRS refers to ’’a complex pathophysiological disorder of the heart and the kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ.’’ This has generated five distinct syndromes upon which the epidemiology of CRS can be described. Acute cardiorenal syndrome (CRS Type 1): acute worsening of cardiac function leading to acute renal injury and/or dysfunction. This is a syndrome of worsening renal function (WRF) that frequently complicates acute decompensated heart failure (ADHF) and acute coronary syndrome (ACS). The mechanisms by which the onset of acute HF or acutely decompensated chronic HF leads to AKI are multiple and complex.