As Marcos López-García explained, this project blends two separate simulations, the river and the waterfall, and uses an air field to boost realism. This waterfall marks the artist's first attempt at fluid simulations, rendered using Karma XPU, and this time, he wasn't able to push the resolution further because his PC ran out of disk space during the caching process.
Check out some of his other recent projects, like this building on fire with simulations created using Houdini's Axiom, rendered in Karma, and composited in Nuke, as well as a realistic simulation of a car crashing through a wall, and more: