Herein, we describe pathological changes in a 17-year-old female black spider monkey (Ateles chamek) that presented with clinical, echocardiographic and morphological evidence of chronic renal dysfunction leading to cardiac disease. At echocardiographic examination, cardiac hypertrophy, right pulmonary artery branch rigidity and diastolic and systolic dysfunction were identified. At necropsy, there was pericardial effusion and the heart was diffuse and markedly enlarged, with thickening of the left ventricular wall and interventricular septum. Both kidneys were small, firm and irregular. Microscopically, there was hypertrophy of cardiomyocytes and myocardial interstitial fibrosis. Renal changes were compatible with nephrosclerosis and hypertensive vasculopathy. Hypertensive arteriolar changes were also present in small vessels of the spleen. Based on the clinicopathological findings, a diagnosis of cardiorenal syndrome was made. Our findings indicate that the cardiorenal syndrome in this black spider monkey was remarkably similar to that reported in humans. Early attention and monitoring for evidence of cardiac involvement should be provided in cases of chronic kidney disease in non-human primates.