Background: acute kidney injury and worsening of renal function is common in patients withrnacute decompensated heart failure, and development of this entity affects patientâ€™s morbidityrnand mortality. rnObjectives: The main objective of this study was to assess the prevalence, and associatedrnfactors for development of WRF in admitted ADHF patients. rnMethods: This was a prospective, hospital-based study of cardiac patients admitted to TASHrnbetween June, 2021 and October, 2021. A structured questionnaire was used to collectrnparameters on sociodemographic characteristics, comorbidities and clinical profile ofrnpatients. Trained physician data clerks collected the data from the chart, interview andrnelectronic medical records. Data was entered into SPSS version 26 for analysis. Bivariate and rnmultivariate binary logistic regression analyses was done to identify factors associated withrnAKI and WRF, Statistical significance was considered at the level of significance of 0.05%, andrnadjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present thernestimates of the strength of the association. rnResult: A total of 104 patients were included in the study. 64(61.5%) were male and 40(38.5)rnwere female. The prevalence of AKI was 21.2% and the prevalence of WRF was 37.5%. Thernodds of developing AKI in smokers was 3.7 times higher [AOR= 3.7; 95% CI: (0.86, 13.18)]. rnConclusion: This study demonstrated that WRF is frequent finding complicatingrnmanagement of ADHF patients.