Q: This is regarding my 2 months old daughter (second of the twin) who came through caesarean after 1.5 hrs of her sister’s arrival. When she was born, there was no heartbeat and had asphyxia. After 25 minutes she started breathing through artificial respiration. She was then on a ventilator in the critical childcare unit with no sign of CNS on the first day. But from the second day CNS was clear but still on loads of antibiotics as her beats were not normal. Then her weight started increasing abnormally. The doctors declared that it was renal failure. Her S. creatinine level started increasing and went up to 7.2 but urination was normal. But her calcium, potassium and haemoglobin were reducing. The doctor said that it is because of the renal problem but then S. creatinine started reducing and urination and weight became normal. Today it has come down to 2 with S. urea also varying along (now it is 80). In between, she was experiencing slow hiccups and the same is becoming normal with calcium injections and haemoglobin supplements. My question is how long this will continue? What actions should I take to improve her?

A:It appears that your child suffered from lack of oxygen during the time of birth. This situation can occur during any delivery, but is more common in second of twins. This lack of oxygen can affect many body parts including kidneys. The resulting renal failure is usually reversible. However, the last urea & creatinine reports of your child are still not normal. Acute renal failure due to a birth related insult should have settled by now. If her urea and creatinine fail to show a further decline, her kidneys shall require a detailed evaluation including an ultrasound and may be a renal scan. It is also important to follow the development of these children carefully because birth asphyxia may cause some brain damage too, leading to adverse influence on a child's growth.