Increased OPN-levels were associated with prevalent SGHS (odds ratio 2.50, p < 0.001), and higher risk of hospitalization for acute kidney failure (hazard ratio (HR) 4.66, p < 0.001) as did prevalent SGHS (HR 4.82, p < 0.001).<h4>Conclusions</h4>In HF patients, OPN was associated with a higher prevalence of SGHS and both OPN and SGHS were associated with higher risk of hospitalization for kidney failure. Here, SPP1 is linked to hydrops fetalis.