Heart failure is widespread and associated with a high mortality rate in chronic kidney disease. However, the pathophysiology of cardiac dysfunction in chronic kidney disease, especially in latent renal disease, is poorly understood. Disability and high mortality in patients with cardiorenal syndrome dictate the need to study the mechanisms of development of heart failure in chronic kidney disease. This literature search review used PubMed and Google Scholar to identify the mechanisms of heart failure in chronic kidney disease. The study of scientific data over the past 5 years has shown that cardiorenal syndrome, which has a complex and multifactorial pathophysiology, is a clinical problem. Diagnostic, prognostic, and therapeutic measures for cardiorenal syndrome are limited. Modern pharmacological methods of treatment are effective, but insufficient to satisfactorily influence or mitigate the progression of cardiorenal syndrome, therefore, the discovery of new drugs and new therapeutic strategies for cardiorenal syndrome is a high priority task. Treatment of patients with cardiorenal syndrome should be comprehensive and continuous, aimed at eliminating physical and psychosocial symptoms.