Recently, there has been increased appreciation of the identification and management of comorbidities in heart failure patients, and for therapies targeting conventional heart failure signs and symptoms. Renal dysfunction is common in patients with heart failure and is associated with high morbidity and mortality. Early identification of renal damage through novel biomarkers and the use of new pharmacological strategies aimed at preserving renal function may represent an important objective in the treatment. This article reviews the epidemiology and pathophysiology of cardiorenal syndrome in heart failure, and highlights novel biomarkers and improved therapies targeting renal dysfunction.