Type Ⅳ cardiorenal syndrome plays an important role in the mortality and prognosis of patients with chronic kidney disease（CKD）. At present，the understanding of the pathogenesis of type Ⅳ cardiorenal syndrome is not comprehensive，and current treatment methods cannot effectively control the life threat of type Ⅳ cardiorenal syndrome to CKD patients. Therefore，it is necessary to further explore the pathogenesis of type Ⅳ cardiorenal syndrome and develop new effective therapy methods. This article attempts to review the recent progress in the pathogenesis of type Ⅳ cardiorenal syndrome，which might provide the basis for medicine design and guide clinical diagnosis and treatment.