The cardio-renal syndrome (CRS) can be generally defined as a pathophysiologic disorder includes a broad spectrum of diseases in which heart and kidney are both involved, the CRS classification essentially recognizes two main groups, cardio-renal and Reno-cardiac syndromes, on the basis of "premium moves" of disease (cardiac or renal); both cardio-renal and Reno-cardiac syndromes are then divided into acute and chronic, according to the disease's onset, Five subtypes of the syndromes were identified, abrupt worsening of cardiac function that lead to acute kidney injury called Acute Cardio-renal Syndrome or Type 1 CRS, this appears to be a syndrome of worsening renal function that frequently complicates hospitalized patients with acute heart failure and acute coronary syndrome. When Chronic abnormalities in cardiac function (e.g. chronic congestive heart failure) cause progressive and potentially permanent chronic kidney disease this condition called chronic cardio-renal syndrome or Type 2 CRS, CKD has been observed in 45-63% of CHF patients24, 25, 26, [10]. The number of participants in the questionnaire is 100 and the questionnaire was distributed in two ways. In the first way, the questionnaire was published on social media and the number of participants was 79 and the number of pharmacists participating in the electronic questionnaire was 51 and the number of participating physicians was 28. In the second way, the questionnaire was distributed to a group of private pharmacies in Baghdad, which numbered 21 and purpose of the questionnaire was to find out if the participants had any information about Cardio-renal Syndrome. Heart and kidney interactions are complex and the subject of immense clinical and scientific interest and debate. In this article, we argue that without consensus on definitions and classification, clinicians will not be able to precisely phenotype the various forms of cardio-renal syndrome. Such phenotyping, in turn, forms the basis for in vitro and animal studies, as well as small translational studies in patients. Through the ADQI consensus on CRS, other processes will now be facilitated, including a better or clearer understanding of the epidemiology of these conditions, opportunities for early diagnosis through biomarkers, the development of preventive strategies and application of evidence-based management strategies