NPPB and hydrops fetalis: Although they both are important indicators of HF (12), NT-proBNP is rarely used as a diagnostic biomarker for HF in patients with end-stage renal disease (ESRD) (13), because ESRD patients without HF have high levels of NT-proBNP due to decreased renal elimination, volume overload, hypertension, and increased left ventricular hypertrophy (14).