AIMS: Chronic kidney disease is a frequent comorbidity in heart failure (HF) patients, affecting prognosis and mortality. This study investigates the relationship between kidney function and adverse kidney events preceding death in HF patients. METHODS AND RESULTS: We analysed registry data of HF patients who died between 2014 and 2021, with at least 1 year of HF diagnosis. Adverse kidney events, including acute kidney injury (AKI) and end-stage kidney disease (ESKD), were assessed. Patients were grouped by estimated glomerular filtration rate (eGFR) 1 year before death: eGFR ≥60, eGFR 30-59, and eGFR<
30 ml/min/1.73 m CONCLUSIONS: In HF patients, AKI and ESKD are common in the last year of life, particularly in those with lower baseline eGFR, with kidney decline accelerating in the final months.