Lauren Trembley

At the age of 17, health concerns were the last thing on Lauren Trembley's mind. An active individual, Lauren played on her high school's volleyball team, made the honor roll and worked a part-time job. She was a typical, energetic teenager.

All that came to a halt, however, in the spring of 2000 when Lauren's kidneys abruptly shut down as a result of lupus, a disease she didn't know she had. Faced with a choice between being on dialysis for the rest of her life or undergoing a kidney transplant, Lauren opted for the transplant.

A silent assault

When Lauren awoke on April 18, 2000, her face was painfully swollen. A trip to the emergency room in her hometown of Red Wing, Minn., revealed she also had dangerously high blood pressure. Those symptoms warranted an ambulance ride to Mayo Clinic in Rochester, Minn. After she was hospitalized for several days and underwent numerous tests, the doctors at Mayo determined Lauren had lupus — a chronic inflammatory disease in which a person's immune system attacks some of the body's own cells. In Lauren's case, the disease had resulted in a complete loss of kidney function.

Although Lauren had noticed she frequently felt tired, she hadn't experienced any other symptoms of health problems prior to the day she went to the hospital. According to Bruce Morgenstern, M.D., a Mayo Clinic pediatric nephrologist and one of Lauren's physicians, that isn't uncommon.

"Kidney disease is incredibly silent in most people," says Dr. Morgenstern. "If you're "lucky," in an odd way, you may get puffy because you're losing protein through your urine. Or, you may see blood in your urine. But, often you can have advanced renal disease without ever noticing any obvious signs."

A clear choice

Lauren's lupus not only caused her kidney failure, it also resulted in a blood disorder, thrombotic thrombocytopenic purpura (TTP). Because of the disorder, Lauren had to wait to receive a kidney transplant. Instead, while her physicians made certain the TTP was under control, she underwent six months of kidney dialysis — three, three-hour appointments each week.

"We had to confirm that the treatment for Lauren's TTP was effective," says Dr. Morgenstern. "That meant observing her for a while to make sure the disorder didn't recur. Because if it did recur after a transplant, it could just as easily destroy the new kidney as it did her old ones."

In October, Lauren received the go-ahead for a transplant. "When they gave me the option of continuing dialysis or having a transplant, I went with the transplant right away," says Lauren. "The dialysis kept me alive, and I'm grateful for that. It tired me out, though, and dragged me down. It was not something I wanted to live with for the rest of my life."

Several of Lauren's relatives were tested as possible kidney donors. The results indicated her mother was a good match. "I was relieved to find out that my mom could be the donor. It seemed right that I would have something that was part of her," says Lauren. "She'd do anything for me. She tells me that all the time. I am so thankful to have that kind of support."

On October 6, 2000, Lauren had her kidney transplant at Rochester Methodist Hospital. After several worrisome days immediately following the surgery, when it was unclear if her body would accept the new organ, Lauren's recovery began in earnest and continued to progress smoothly.

Of her time in the hospital, Lauren recalls that the staff was instrumental in calming her fears. "When I got my transplant, I was only seventeen years old, and I was as scared as can be," she says. "The nurses and doctors made sure I understood everything. They were always there if I had any questions, and they talked to me in language so I could understand what was going on. That made me feel a lot better about my situation."

A return to normalcy

After a week in the hospital and a month when she had to remain in Rochester for frequent blood tests and check-ups, Lauren was able to return home and go back to school. In May of 2001, she graduated from high school right along with the rest of her class.

After graduation, she attended college, earned her cosmetology license and is currently studying to become a dental assistant. Lauren also is back to enjoying her favorite activity, volleyball. She plays in several volleyball leagues and coaches teams of fifth and sixth graders for the Junior Olympics program. Although she continues to need periodic check-ups at Mayo Clinic, Lauren has not experienced any problems with her kidney or any complications due to her lupus since the transplant.

This return to a normal life is just what Dr. Morgenstern likes to see. "Individuals who successfully undergo a kidney transplant should be able to continue their regular business," he says. "There are some things we prefer that they not to do. We advise they not play ice hockey, for example, or other contact sports. Otherwise, we expect they will be able to resume their previous level of activities."

For Lauren, the results of her transplant have been welcome relief. "When I was first diagnosed with lupus, and they told me I needed a kidney transplant, I thought it was going to be the end of my life as I knew it. I thought everything would change," she says. "But now, looking back, it doesn't seem that bad. Things are back to normal for me, and the experience hasn't changed my life that much at all. With the support of my family and friends, and the great care I got at Mayo, everything turned out just fine."