ALB and chronic kidney disease: The microvascular hypothesis of HFpEF finds more support if we transcend the anatomic boundaries of the heart: while it is known that chronic kidney disease (CKD) strictly pairs with HFpEF by fostering inflammation through uremic toxins increase, urinary sodium retention, and altered levels of endocrine factors (Ter Maaten et al., 2016), Shah and colleagues described a link between CMD and CKD through the evidence that patients with worse CFR have a higher urinary albumin-to-creatinine ratio (ACR) (Shah et al., 2018).