Two and a half years ago, Marciana Laster, MD, MS, joined the Indiana University School of Medicine Department of Pediatrics to bring more awareness to kidney disease, but her journey in medicine started when she was very young — telling her mom she wanted to be a doctor when she was just 4 years old.
When her boyfriend, who is now her husband, became sick with a ruptured appendix and complicated appendicitis, Laster was reminded about her childhood goals. The desire to understand the health of the whole family solidified her quest for her place in the medical field. She completed her undergraduate degree on the pre-med track at Loyola University Chicago, then went to Northwestern Medical School in Chicago. She completed her residency training in Los Angeles at the University of Southern California, followed by a fellowship to become a nephrologist (kidney doctor) at UCLA before joining IU and Riley Children’s Health, where she currently works with patients.
Bone density and transplant timing
Laster is in a period of transition as she is becoming an independent researcher with her own lab at the IU School of Medicine. She focuses on two areas of research: the link between kidney failure and bone health, and access to kidney transplantation.
Current funding from the National Institutes of Health allows Laster to focus on the link between kidney failure and bone density.
“When kidneys fail, whether that be in adults or children, the bones become very abnormal,” Laster said. “We've learned, over time, that there's an interaction between the kidneys and the bone. When the bones break, they grow abnormally.”
Additionally, there is an interaction between bones and the heart. Children can develop calcifications, the buildup of calcium in the heart's tissues, affecting their hearts.
Her focus on bone disease is really an effort to understand the heart disease that kids deal with and to figure out how to treat these young patients in a way that promotes long-term outcomes and survival.
The second area of her research focuses on access to kidney transplants. In hopes of not keeping kids on dialysis longer than necessary, Laster aims to figure out how to get pediatric patients to the transplant stage as soon as possible. She is working to discover what the barriers are that may be standing in the way, so children are not spending unnecessary time waiting for a kidney transplant.
A passion for pediatric medicine
Lester’s dedication to healthcare continues into her personal time, where she volunteers by teaching elementary through high school-age students about kidneys through different panels or class presentations. Armed with her white coat and clean scrubs, Laster aims to make every volunteer opportunity a chance for children to interact with the medical field through various games and hands-on kidney models.
“I just love being a part of that volunteer effort,” Laster said. “It's really cool that this award acknowledges my achievements, but it's even better because it's through a program or through a place that I really believe in.”
Laster said she’s incredibly energized by working with elementary school students and recalled one of her favorite memories from volunteering.
“At the end of my presentation where I was being a little bit more risky, I had come up with a game to share some models with the kids,” she said. “I didn't really know how they would take it, but a few of the kids came up and gave me a hug afterwards.”
Feeling as if she might not have left the kids with much, the fact that they hugged her made her feel like she was able to leave her audience with something to ponder after the game was over.
Laster has always loved connecting with kids, especially those who may have similar journeys. A personal obstacle she has overcome is hearing loss. While a doctor wearing hearing aids is not very common, it allows Laster a chance to create meaningful connections with her patients.
“I love to take them out when kids have hearing aids,” Laster said. “I have a special stethoscope that helps me to hear despite my hearing loss, and I've just kind of gotten used to navigating the situation.”
What caregivers and future physicians should know
March is National Kidney Month, and Laster has some tips for parents, guardians and caregivers.
“I would advise them that it is not too early to think about the health of your kidneys, because the habits that our kids develop in childhood are the habits that they carry into adulthood,” she said.
With the top two causes of kidney failure as adults being high blood pressure and diabetes, teaching kids to develop healthy habits right now is going to impact their ability to have healthy kidneys in the future. Eating healthy, limiting sugary drinks, drinking water daily, and monitoring salt intake in young people can help them develop healthier habits when they reach adulthood.
In hopes of giving patients the best care possible, one passion of Laster’s is encouraging younger people to go into medicine and particularly into being a doctor. Doctors of all varieties and lived experiences are incredibly important to patient care. Laster hopes young people seize every opportunity to explore medicine.
“Because the more you see of the field,” she said, “the more you will see yourself in the field.” That's what drove her to pursue a career in medicine: “I could see it as a possibility. It didn't seem too big for me. It seemed like I could fit here.”
