Knowing that discriminatory ability of renalase for ischemia prediction in patients with HF, regardless of the ejection fraction, was similar to those of BNP, sST2, galectin-3, and GDF-15, we are not offering renalase as a sole marker of ischemia prediction, but implying its potential contribution to ischemia-risk stratification, through multiple biomarker protocols. Here, RNLS is linked to hydrops fetalis.