Chronic kidney disease (CKD) is a well-established risk factor for heart failure (HF); however, patients with an estimated glomerular filtration rate (eGFR)<30mL/min/1.73m2 have been systematically excluded from clinical trials. This study investigated the incidence of HF and kidney outcomes in HF patients with and without advanced CKD, that is, eGFR<30. From nationwide registries, HF patients were identified from 2014 to 2018 and categorized into three groups according to baseline eGFR (eGFR≥60, 60>eGFR≥30 and eGFR<30). The incidence of primary outcomes (all-cause mortality, HF hospitalization, end-stage kidney disease and sustained 50% eGFR decline) was estimated using cumulative incidence functions. Of the 21959 HF patients included, the median age was 73.9years, and 30% of patients had an eGFR between 30 and 60 and 7% had an eGFR<30. The 4year incidence of all-cause mortality was highest for patients with eGFR<30 (28.3% for patients with eGFR≥60, 51.6% for patients with 60>eGFR≥30 and 72.2% for patients with eGFR<30). The 4year incidence of HF hospitalization was comparable between the groups (25.8%, 29.8% and 26.1% for patients with eGFR≥60, 60>eGFR≥30 and eGFR<30, respectively). For patients with eGFR<30, kidney outcomes were four times more often the first event than patients with eGFR>30 (4year incidence of kidney outcome as the first event was 5.0% for eGFR≥60, 4.8% for 60>eGFR≥30 and 20.1% for eGFR<30). Patients with advanced CKD had a higher incidence of mortality and poorer kidney outcomes than those without advanced CKD, but a similar incidence of HF hospitalizations.