The past two decades have witnessed a profound shift in how clinicians and researchers understand the interactions between the heart and the kidneys. No longer viewed as separate entities affected merely by shared risk factors, the cardiovascular and renal systems are now recognised as being tightly interwoven in a bidirectional continuum. Globally, both chronic kidney disease (CKD) and cardiovascular disease (CVD) have reached epidemic proportions, each amplifying the burden of the other and disproportionately affecting ageing populations, individuals with multimorbidity, and socioeconomically vulnerable groups. Cardiovascular mortality remains the leading cause of death among patients with CKD, while even mild renal impairment significantly worsens outcomes across nearly all cardiovascular conditions—from acute coronary syndromes and arrhythmias to heart failure and structural heart disease.