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In February 2014, Sondra Kunes was feeling a little more fatigued than usual, but wrote it off as being 54 and raising five children ranging from their early teens to early 20s. Several years earlier she had undergone bariatric surgery for weight loss, and had read that some gastric bypass patients suffered from anemia, so she went to her doctor to get checked out.
"Nothing was wrong with my blood work, but my protein was quite low," she recalled. By May, when she put on her sandals on a warm day and noticed that her feet were swollen, she went back. A 24-hour urine test showed that she was excreting a great deal of protein, so Mrs. Kunes was sent to a nephrologist for a kidney biopsy.