140 step in the genesis of cachexia, being renal and cardiac dysfunction closely related to the occurrence of systemic congestion, a central player in the theory of LPS translo- cation and immune activation, and to neurohormonal activation, with consequent catabolic/anabolic imbalance, as previously discussed. In conclusion, the heart and kidney are players of the same game at different levels, and when cachexia is involved, we may plausibly talk about CRCS. Complex interrelations may explain the transition from CRS to cachexia and from cachexia to CRS. Identification of the exact mechanisms occurring in these conditions could potentially help in preventing and treating this deadly combination. Acknowledgement The authors of this manuscript certify that they comply with the Principles of Ethical Publishing in the Journal of Cachexia, Sarcopenia, and Muscle [104]. 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