The cardiorenal syndrome type 4 (Chronic Renocardiac Syndrome) is characterized 
by a condition of primary chronic kidney disease (CKD) that leads to an 
impairment of the cardiac function, ventricular hypertrophy, diastolic 
dysfunction, and/or increased risk of adverse cardiovascular events. Clinically, 
it is very difficult to distinguish between CRS type 2 (Chronic Cardiorenal 
Syndrome) and CRS type 4 (Chronic Renocardiac Syndrome) because often it is not 
clear whether the primary cause of the syndrome depends on the heart or the 
kidney. Autosomal dominant polycystic kidney disease (ADPKD), a genetic disease 
that causes CKD, could be viewed as an ideal prototype of CRS type 4 because it 
is certain that the primary cause of cardiorenal syndrome is the kidney disease. 
In this paper, we will briefly review the epidemiology of ADPKD, conventional 
and novel biomarkers which may be useful in following the disease process, and 
prevention and treatment strategies.