There is substantial causal and consequential interaction between the ever-growing heart failure and renal failure patients. Half of the patients with heart failure (HF) have preserved left ventricular ejection fraction (HFpEF), which is difficult to diagnose and rising in prevalence relative to HF with reduced EF (HFpEF). To date, only weight reduction, exercise training, and diuretics have been shown to improve exercise tolerance and morbidity in HFpEF. This review aims to establish the baseline kidney-related concepts specific to the diagnosis and treatment of HFpEF patients and the different aspects of HFpEF and HFpEF in the clinical setting.