The year of 2018 marked an exciting phase in the field of cardio-nephrology with several new developments impacting the care of patients with the dual burden of heart and kidney disease. Novel approaches to older patho-physiological principles in cardiorenal syndrome, new drug therapies with major cardio-renometabolic benefits, increasing momentum for the call for the need for a “cardio-nephrology” sub-specialty as well as deserved prominence for cardio-renal research in major cardiology and nephrology publications and conferences represent some of these exciting changes. In this editorial, we summarize some of the key work that impacted the field of cardio-nephrology in a meaningful way in 2018, thereby setting the stage for more fertile growth and expansion for the future.