Patients with coexisting heart failure (HF) and renal dysfunction (RD) face a significantly poorer prognosis compared to those with HF alone, experiencing higher rates of hospitalization, mortality, and morbidity. Managing patients with heart failure with reduced ejection fraction (HFrEF) and renal dysfunction (RD) is challenging due to the risk of further worsening of kidney function, particularly following an episode of acute decompensated heart failure (ADHF). Initiating a