Patients with chronic kidney disease (CKD) have a high risk of cardiovascular diseases and their consequences myocardial infarction, heart failure, valve diseases, arrhythmias, and sudden cardiac death. Although the incidence and prevalence of cardiovascular diseases are already increased in patients with early stages of kidney insufficiency (CKD 1–3) compared to the general population, patients with advanced kidney insufficiency have a significantly increased morbidity and mortality risk. In these patients, cardiovascular diseases—and not kidney failure—are the leading causes of death. Regarding the diagnostic possibilities for the detection of cardiovascular diseases, the currently used methods are limited in their informative value in CKD. Similarly, there are limitations in the therapeutic options, as patients with advanced kidney disease are often excluded from clinical studies.