The coexistence of heart and kidney diseases, also called cardiorenal syndrome, is increasingly common, leads to a significant impact on morbidity and mortality, and poses diagnostic and therapeutic difficulties. There is a risk-treatment paradox, such that patients with the highest risk are treated with lesser disease-modifying medical therapies. In this document, different scientific societies propose a practical approach to systematically address and optimize cardiorenal therapies and related comorbidities in chronic cardiorenal disease beyond congestion. Cardiorenal programs have emerged as novel models that may assist in delivering coordinated and holistic management for these patients.