Aim To explore the characteristics of renal function changes in patients with ischemic heart failure (HF) during hospitalization. Methods Patients with ischemic HF hospitalized in the Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University from October 2013 to December 2017 were retrospectively included. Descriptive statistics was used to describe the baseline clinical features of patients. Multivariate Logistic regression model was used to explore the related factors of worsening renal function (WRF) in ischemic HF patients. Results 797 patients with ischemic HF were enrolled in this study, with an average age of (70.5±11.1) years, of whom 68.9% was male. Among them, 22.5% was HF patients with reduced left ventricular ejection fraction (LVEF) and 57.6% was HF patients with retained LVEF. The incidence of WRF was 18.4%. The related factors leading to WRF included high serum creatinine (OR＝1.953, P＜0.001), history of hypertension (OR＝1.859, P＝0.025), low hemoglobin (OR＝0.985, P＝0.002), high fibrinogen (OR＝1.241, P＝0.013), high blood chlorine (OR＝1.042, P＝0.049), high blood uric acid (OR＝1.002, P＝0.039) and using furosemide (OR＝1.773, P＝0.033). Conclusion The incidence of WRF in ischemic HF patients is high, and there are many related factors; Clinically, it is necessary to pay attention to the changes of patients' renal function and control related factors in time, especially low hemoglobin, high fibrinogen, high blood chlorine and high blood uric acid.