Larry E. Fleischman, MD (2016)

A fond farewell to a dear friend and a colleague
Tej K. Mattoo and Rudolph P. Valentini
Nephrology team at the Children’s Hospital of Michigan/Wayne State University

Dr. Larry E. Fleischmann, MD, a pioneering Pediatric Nephrologist, Professor Emeritus of Pediatrics at Wayne State University, and the past president of Children’s Hospital of Michigan, died on December 23, 2016 at the age of 79. Larry was one of the first pediatric nephrologists in the country. He did his MD in 1963 at The Johns Hopkins School of Medicine, Baltimore, followed by Residency in Pediatrics at the same institution. He spent two years at The National Institutes of Health in Dr. Fredrick Bartter’s Lab. Larry joined Children’s Hospital of Michigan (CHM)/ Wayne State University (WSU) in 1967 as Chief Resident and Instructor in Pediatrics. In 1969, he became Board certified in Pediatrics and in 1974 he was in the first batch of Sub-Board examination for Pediatric Nephrology.

Larry’s career at CHM spanned 48 years. In 1969, he established the 1st Pediatric End-Stage Renal Disease program in the State of Michigan. This included dialysis facilities for children, which he started in a converted sewing room in hospital basement.  Soon after, in 1970, he initiated the first cadaveric kidney transplant program in the State. During his tenure, Larry had numerous leadership roles, which included Chief of Nephrology, Director of Pediatric Education, Vice-Chair and Interim Chair of Pediatrics, Chief of Staff at CHM, Senior Vice President and President of the CHM, Trustee and Interim President of the Children’s Hospital of Michigan Foundation. He retired from clinical service at the end of 2015.

Larry was a brilliant clinician and a gifted educator. His fervor for spinning urine samples and doing microscopic examination during clinic visits and teaching the same to others was inspiring. Larry trained generations of medical students and pediatric nephrologists.  He was a wonderful colleague and a delightful human being with an incredible sense of humor and a unique knack of being blunt when appropriate.  Larry was also an avid and a competitive golfer throughout his adult life and won many championships. A loyal member of the Detroit Golf Club, he was pleased that he could pursue his profession yet remain competitive at “a pretty fast track.” Traveling to Cape Cod for the American Seniors Golf Association Clam Bake tournament was a pleasure he looked forward to every year. Larry’s other passion that he shared with this wife was thoroughbred horse racing.

During his career, Larry received numerous awards. These include, the School of Medicine’s “Pathfinders in Medicine” award, the College of Nursing’s “Lifeline Award”, the University of Detroit’s  ” Science Alumnus of the Year” award, the Kidney Foundation’s “Champion of Hope” award, and the March of Dimes “Humanitarian of the Year” award. In recognition of his distinguished career at CHM, last year the hospital named its dialysis center after him as the “Larry E. Fleischman M.D. Pediatric Dialysis Center”. The dedication ceremony was attended by Larry and his family and friends.
Larry is survived by his beloved wife Pat (Margaret), who he met at high school and was married to for 59 years, three sons and two grandchildren.

We are profoundly grateful for all Larry did for all of us, our program and the institution. We are far richer to have known him and will miss him dearly.

Memorial donations can be made to the Larry E. Fleischmann Nephrology Education Endowment Fund at the Children’s Hospital of Michigan Foundation http://chmfoundation.org/

Sharon A. Perlman-Frankel, MD (2016)

June 30, 1953 – December 11, 2016

Sharon A. Perlman, MD, a brilliant physician and compassionate human being, passed away at age 63 on December 11, 2016 after a long and courageous battle with cancer. Sharon was an extraordinarily dedicated and effective leader of ASPN

Sharon was born on June 30, 1953 and raised in Weehawken, New Jersey. She graduated from Bard College and received her medical degree from Albert Einstein College of Medicine in New York City. She was the Chief Resident in Pediatrics at Emory University and completed her fellowship in Pediatric Nephrology at St. Christopher’s Hospital for Children in Philadelphia.

Sharon initially practiced pediatric nephrology at the Medical College of Georgia (MCG) in Augusta, and then spent 6 years in private practice pediatric nephrology in St. Petersburg and Tampa. She joined the University of South Florida (USF) Division of Pediatrics in 1994, and served as the Medical Director of the Dialysis Unit and Division Director of Nephrology at All Children’s Hospital for more than 20 years. She was the Chief of Staff at All Children’s Hospital from 2008-2009. Sharon received a “Teacher of the Year Award” at MCG and three “Attending Physician of the Year” awards at USF, and also received the Councill C. Rudolph Award from Johns Hopkins All Children’s Hospital Medical Staff. In 2015, USF Department of Pediatrics established the Sharon A. Perlman Award of Excellence to be awarded to a graduating resident for excellence in patient care, strength of character, and outstanding leadership.

Sharon was extremely active in the leadership of ASPN. She served on the ASPN council from 2006-2016 and was a Secretary-Treasurer and President-Elect of ASPN. Sharon’s illness prevented her from serving as ASPN President, but she nonetheless continued her dedicated work for the Society. Sharon’s contributions through membership on the Renal Physician’s Association Board, the AMA Practice Improvement Group for Pediatric Nephrology and Kidney Care Partners were invaluable. Her many contacts in, and knowledge of, Congress have been instrumental in our public policy work, and her contributions to the JELF Scholars program at multiple levels–practical, emotional and financial–have been essential to its success. Most of all, Sharon’s ongoing commitment to the missions of ASPN have been paramount. That she has accomplished all that she has for us, while functioning as a pure clinician in a virtually non-academic practice, is remarkable. Sharon’s contributions to ASPN were recognized this year by her receiving the ASPN Founder’s Award, the highest honor that can be given to a member of our society.

Sharon was an avid adventurer and scuba diver. She traveled the world, mostly to explore the undersea treasures. She rescued Greyhounds and was part of the initial Pet Therapy Program with her Greyhounds at All Children’s Hospital, bringing joy to the patients and staff.

Dr. Perlman is survived by her loving and adoring husband, Ron Frankel, two daughters, Jaymie and Meagen, two beautiful grandchildren, Jackson and Allison, her two sisters, Lauren and Robin, and many nephews and nieces.

http://www.davidcgross.com/notices/DrSharon-Perlman-Frankel

William E. Harmon, MD (2016)

July 31, 1943 – May 29, 2016

The American Society of Pediatric Nephrology mourns the loss of Dr. William E. Harmon, who passed away on May 29 2016 at the age of 72 after a prolonged battle with melanoma.

The magnitude and depth of Bill Harmon’s impact on pediatric nephrology, kidney transplantation and dialysis cannot be measured, but continues to advance our field through the initiatives he created, the fellows he trained and the lives of our patients he improved.

Born in Cleveland, Ohio, Bill completed his medical degree at Case Western Reserve University. His post-graduate training in pediatrics and pediatric nephrology were completed at the Boston Children’s Hospital and Harvard University. He then stayed on to undertake a storied career which led him from Instructor to tenured Professor of Pediatrics and the Director of the Division of Pediatric Nephrology at these institutions. Bill was appointed the founding Director of Dialysis and the founding Medical Director of Pediatric Transplantation at Boston Children’s, positions he held with distinction for almost three decades. He worked tirelessly at the local, national, and international levels for the importance of specialized pediatric caretakers for children with ESRD. Bill held leadership positions in many national organizations including the United Network for Organ Sharing (UNOS), the American Society of Transplantation (AST), and the North American Pediatric Renal Transplant Study (NAPRTCS). He served as President of the pediatric committee of UNOS, as President of the AST in 2002-2003, and served as the President of NAPRTCS from 2002-2015.

Bill’s academic activities were focused on all aspects of pediatric dialysis and renal transplantation, training and mentoring, and education. He was the recipient of many national grants from the National Institutes of Health, and published over 200 peer-reviewed papers, invited reviews, and chapters. He served as an editor for the fourth through seventh editions of the standard reference text in the field, Pediatric Nephrology (1999-2016). He delivered over 150 invited lectures and seminars in the United States, Europe and Asia. Bill directed the pediatric nephrology training program at Boston Children’s, and his trainees have achieved national and international leadership positions. Bill received lifetime achievement awards for his many contributions from the American Academy of Pediatrics in 2007 (Henry L. Barnett Award) and the American Society of Pediatric Nephrology in 2013 (Founders’ Award). At his acceptance speech for the ASPN Founder’s Award a few years ago, he reminded us that “we are privileged to be in a position to take care of children”. Bill never took that privilege lightly.

Bill will be dearly missed by his patients, his trainees, and his colleagues. His family has set up a website to celebrate his life and accomplishments:
http://www.williamharmonmd.com

Charles Plante (2015)

Charles L. Plante, a lobbyist for the National Kidney Foundation who was credited with playing a pivotal role in enacting the legislation that authorized Medicare coverage for dialysis treatments for kidney disease patients, died Dec. 21 at his home in Middleburg, Va. He was 84.

August 8, 1931 – December 21, 2015
Obituary

Russell Wallace Chesney, MD (2015)

– A Fond Farewell
Aaron Friedman and Robert Wyatt

Russell Wallace Chesney   MD died on April 2, 2015 in Memphis Tennessee. He was 73 years old. Russell, or as many called him Russ, was a major figure in pediatrics and pediatric nephrology for over 40 years. Born August 25, 1941 in east Tennessee, he was raised in Knoxville, Tennessee and completed his secondary education at St Andrew’s School in Delaware. Russell received a Bachelor’s degree from Harvard University, Cambridge, Massachusetts, and his MD degree from the University of Rochester, Rochester, New York. He began his medical research career at the University of Rochester and while completing an internship and residency in pediatrics at the Johns Hopkins University, he continued his research training at the National Institutes of Health in Baltimore, Maryland. From Johns Hopkins, he moved to McGill University in Montreal, Canada where he completed fellowships in pediatric nephrology and genetics. He trained with great mentors such as Jordan Cohen, Bertram Sacktor, Barton Childs, Robert Cooke, Harold Harrison, Keith Drummond and Charles Scriver. In 1975, he joined the faculty of the University of Wisconsin, moving in 1985 to the University of California, Davis and then, in 1988, he became professor and Chair of Pediatrics at the University of Tennessee, Memphis, Tennessee and the Le Bonheur Children’s Hospital. He served in those roles at the University of Tennessee and Le Bonheur Children’s Hospital until his return to the faculty of the University of Tennessee in 2011.

Dr. Chesney contributed to the advancement of pediatrics and pediatric nephrology at a local, national and international level. He was an excellent clinician and superb academician. Dr. Chesney published over 360 original manuscripts, nearly 180 book chapters and numerous letters to editors and abstracts. Throughout his career, he was sought after speaker across the globe. His areas of contribution included, pediatrics, nephrology, education and workforce development. We would like to cite a few examples of the importance and breadth of his contributions.

In the late 1970’s, Dr. Chesney and his colleagues were among the first to publish the use of 1,25 dihydroxyvitamin D3 in children to treat the hypocalcemia, bone disease and the growth failure of renal osteodystrophy [1-3]. He continued to work in this area of interest and on rickets, in general, throughout his career. His basic science laboratory interest was in the developmental aspects of amino acid transport in the kidney. He used taurine as his “model” amino acid. He published extensively on this subject with his earliest taurine transport publication in 1979 [4] and his most recent publication in 2013[5]. In 1980, Dr. Chesney was one of the first to describe the use of the antihypertensive, [angiotensin converting enzyme inhibitor] captopril, in children [6]. He teamed with his wife, Joan Chesney MD, to provide one of the earliest descriptions of toxic shock syndrome and its many clinical manifestations [7,8]. He published widely on hemolytic uremic syndrome [9], fluid and electrolyte management and workforce development in North America, in pediatrics and pediatric nephrology. Over the past decade, Dr. Chesney served as study chair of the NIDDKD supported Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR) [10].   He was brilliant but also continuously curious, always asking why and encouraging others to heighten their own curiosity and to act on their questions.

The above contributions would, for most, be a truly remarkable career.   But Dr. Chesney took on, very successfully, leadership positions at local, national and international levels. He was the Chair of a large, diverse and successful Pediatrics Department and part of the leadership team at a very well respected Children’s Hospital. He was a leader within: the American Society of Pediatric Nephrology [ASPN] and was its President [1985]; the Midwest Society for Pediatric Research and served as it President [1986-1987]; the Society for Pediatric Research [SPR] as President [1987]; the American Pediatric Society [APS] as President [2003-2004]; the American Society of Pediatric Department Chairs as President [2001-2003]. He served the American Academy of Pediatrics [AAP] as Chair of its Council on Pediatric Education [1989-1992] and as Chair of the Committee on Pediatric Research [1999-2004]. He was a member of the Board of Directors of the American board of Pediatrics and was its Chair [2001]. He was a leader of the International Pediatric Nephrology Association [IPNA] and editor of our journal, Pediatric Nephrology from 1997-2004. We all turned to Russell for his wisdom and insights and he gave of himself, tirelessly, throughout his career.

Dr. Chesney was honored for his many contributions with the Meade Johnson Award [SPR] in 1985; The Joseph St Geme Award given by the Federation of Pediatric Organization in the USA [2001]; the Ira Greifer Award from IPNA in [2010]; the Tennessee Chapter of the AAP Lifetime Achievement Award [2011] and highest award in pediatrics in the United States, the Howland Award from the APS in 2011.

Dr. Chesney’s career was truly remarkable. He did so much and did it so well. We will remember him, not only for what he did, but also for his personal qualities. Everyone knew Russell- from his publications and lectures, from his ubiquitous presence at meetings and his erudite questions. We know him for his prodigious knowledge and his exceptional memory. What is amazing is that we all felt Russell knew us. He was approachable, willing to listen and help and generous with his time and ideas. Many considered Russell a mentor and one who influenced them and helped them succeed. Joan Chesney said of Russell, ” He does not take himself seriously but he takes what he does very seriously.”

We are profoundly grateful for all Russell did for us, lucky to have had the work with or learn from him and saddened to lose him.

 

1 Chesney RW, Horowitz SD, Kream BE, Eisman JA, Hong R, DeLuca HF. Failure of conventional doses of 1 alpha dihydroxy cholecalciferol to correct hypocalcemia in a girl with idiopathic hypoparathyroidism. N Eng J Med 297: 1272-1275, 1977.

2 Chesney RW. 1,25 vitamin D3 in reversal of secondary hyperparathyroidism in uremic osteodystrophy. N Eng J Med 298: 1424-1425, 1978

3 Chesney RW, Moorthy AV, Eisman JA, Jax DK, Mazess RB, DeLuca HF. Increased growth after long term oral 1 alpha, 25 dihydroxyvitamin D3 in childhood renal osteodystrophy. N Eng J Med 298:238-242, 1978.

4 Chesney RW, Jax DK, Developmental aspects of renal beta amino acid transport I: Ontogeny of taurine reabsorption and accumulation in rat renal cortex. Pediatr Res. 13:854-860, 1979

5 Han X, Chesney RW. Knockdown of TauT expression impairs human embryonic kidney 293 cell development. Ad Exp Med Biol 776:307-320, 2013.

6 Friedman AL, Chesney RW, Ball D, Goodfriend T. Effective use of captopril [angiotensin converting enzyme inhibitor] in severe childhood hypertension. J Pediatr 17:664-667, 1980

7 Chesney PJ, Chesney RW, Purdy WK, Davis JP. Toxic Shock Syndrome in the United States MMWR 29:229-236, 1980

8 Chesney JP, Davis JP, Purdy WK, Ward PJ, Chesney RW. Clinical manifestation of toxic shock syndrome. JAMA 246:741-748,1981

9 Kaplan BS, Chesney RW, Drummond KN. Hemolytic uremic syndrome in families. N Engl J Med 292: 1090-1093, 1975

10 RIVUR Trial Investigators, Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, Pohl HG, Kropp BP, Skoog SJ, Nelson CP, Moxey-Mims M, Chesney RW, Carpenter MA.. Antimicrobial prophylaxis for children with vesicoureteral reflux, N Engl J Med 370: 2367-2376, 2014

Ira Greifer, MD (2014)

The Pediatric Nephrology community has lost a unique advocate and compelling voice for children with the passing of Ira Greifer, MD, Professor Emeritus of Pediatrics at the Albert Einstein College of Medicine. Dr. Greifer passed away on September 17, 2014, in New York City. His early career was mentored by Dr. Henry Barnett, the first Chair of Pediatrics at the Einstein College of Medicine at a time when the field of pediatric nephrology was being defined at that institution by Dr. Barnett in collaboration with Chester Edelmann, Jr. and Adrian Spitzer.

Dr. Greifer’s extensive contributions to our subspecialty encompass legislation on and delivery of health care, advocacy on behalf of children¹s needs, support of research and education in pediatrics and the subspecialty of nephrology, and advancing an international effort in pediatric health care via the International Pediatric Nephrology Association.

Dr. Greifer first came to Albert Einstein College of Medicine 60 years ago and was the former Director of Pediatrics at the College Hospital where in the mid-1960s he began developing a number of “firsts” in the country for both patients and families, including the following innovations:

  • A family-centered care program called Mothering in Hospital Program, which permitted parents to sleep at their child’s bedside during hospitalization and also included the first ambulatory surgery program in the state of New York
  • The only mainstreaming summer camp program for children on hemodialysis in partnership with the Frost Valley YMCA and the Eva Gottscho Foundation, which has served over a thousand children with special needs
  • A leadership role in the passage of national legislation entitling patients with kidney failure to receive dialysis and transplantation, and a vital collaboration with with then-Senator Jacob Javits fostering kidney research, including the establishment of the Kidney Disease Institute of New York State

Dr. Greifer was the former medical director of the National Kidney Foundation and President of the Kidney and Urology Foundation of America, and served on many scientific councils. Through his vision he made possible the funding of training fellowships in nephrology, nutrition, social work, and nursing that to date have supported over 1,000 recipients. He also was one of the founders of IPNA and served as the Secretary General.

Dr. Greifer played a critical role in the expansion of the subspecialty, worldwide. In recognition of his continued work with IPNA, Ira served as the Honorary President of the Scientific Congress in New York in 2010. The current IPNA training and educational programs represent his legacy.

Ira’s vision, leadership, and commitment to pediatrics and nephrology are appreciated around the world. He was one of the fathers of Pediatric Nephrology whose leadership and knowledge has improved the lives of countless children with kidney disease worldwide. His legacy is unparalleled and will inspire generations of practitioners and scientists to come.

By Frederick Kaskel M.D., Ph.D and Isidro B. Salusky, M.D.

Robert Vernier, MD (2014)

Robert Vernier passed away on May 2, 2014. He died peacefully of heart failure at his daughter’s home.

As many of you know, Bob Vernier made historic clinical and scientific contributions to pediatric nephrology research and patient care. His early leadership in national and international organizations played an important role in establishing a specialty position for pediatric nephrology. His pioneering application of percutaneous kidney biopsy and electron microscopy to the diagnosis of pediatric kidney disease continue to influence on a daily basis the quality of care provided by pediatric nephrologists. His bibliography catalogues a rich lifetime of important, innovative and prolific basic and clinical research accomplishments matched by few in our field. Bob championed the development of aggressive therapy for congenital nephrotic syndrome with the result that these children routinely survive and lead productive lives after kidney transplantation.

Bob’s collaboration in the 1950s and 1960s with Marilyn Farquhar and Robert Good established percutaneous kidney biopsy as a diagnostic tool in pediatric nephrology and created the foundation for our understanding of the ultrastructure of normal and diseased kidneys. The fundamental importance of this work cannot be overstated, including the first demonstration of the glomerular epithelial cell slit pore filtration apparatus. His bibliography includes landmark studies of childhood nephrotic syndrome, anaphylactoid purpura, renal ontogenesis, the glomerulopathy of cyanotic congenital heart disease, Goodpasture syndrome, postinfectious glomerulonephritis, experimental renal cystic disease, membranoproliferative glomerulonephritis, nail-patella syndrome, congenital nephrotic syndrome, mesangial function, immunosuppressive treatment of lupus nephritis and other nephridities, immune complex formation, dense deposit disease, IgA nephropathy, familial nephritis and the role of the membrane attack complex in glomerulonephritis.

Bob trained several generations of pediatric nephrologists who have practiced, taught and conducted research all over the world. Through his pupils, whom he taught with infinite kindness and patience, his influence will be perpetuated indefinitely. The training program he developed with Al Michael produced well over 100 pediatric nephrologists, the great majority of whom went on to full-time faculty positions. Through the clinical and academic productivity of these physician-scientists Bob exponentially amplified his own extraordinary zeal for clinical care and research.

A further legacy encompasses two organizations he helped to found and lead: the American Society of Nephrology (President, 1979-80) and the American Society of Pediatric Nephrology (President, 1976-77). He gave outstanding service to the National Kidney Foundation, including the founding of the Kidney Foundation of the Upper Midwest. He also served in a variety of capacities for the American Heart Association and the National Institutes of Health and was a member of numerous editorial boards. Bob’s awards included the Distinguished Service to Research Award of the American Heart Association (1972), the Kidney Award (now known as the Henry L. Barnett Award) of the American Academy of Pediatrics (1993), the John Peters Award of the American Society of Nephrology (1996) and the Founders Award of the American Society of Pediatric Nephrology (2008). Bob shared the Peters and Founders Awards with Clark West, another giant of our field.

Bob’s legacy is assured. His name may one day fade from memory, but his influence will be felt wherever children with kidney disease receive care from knowledgeable and compassionate physicians.

Clifford E. Kashtan, M.D., F.A.S.N.
University of Minnesota Children’s Hospital

Malcolm (Mac) A. Holliday, MD (2014)

January 12, 1924 – March 26, 2014
Obituary

Malcolm Holliday,” Mac”, as he was known, was a major figure in pediatric nephrology from its inception to the end of the 20th Century. His early research contributed greatly to our understanding of fluid and electrolyte management, and later his work was central to our understanding of growth failure in children with chronic kidney disease.

Mac’s first foray into the medical literature was as a 3 year old patient when he had a kidney removed, secondary to chronic pyelonephritis. This operation was unusual at the time and the case was published in the Virginia Medical Journal. Years later, while serving as a consultant to the MDRD study which looked at the effect of dietary protein intake on the progression of renal disease, he was asked by eminent nephrologist whether he would become a vegetarian if he had only one kidney. As relayed by Mac, he lifted his fork with steak attached and noted with a smile, that in fact; he did have only a single kidney…
Mac was an excellent student, graduating high school and entering college at 16 and entering medical school, mid-World War II, at age 19. During the war years, medical school was shortened to three years and he graduated Alpha Omega Alpha 3 years later. On graduation day, he married Mildred Wiant, his love and constant companion for the next 63 years.

Mac’s early training was peripatetic; he interned at Boston Children’s hospital, left Boston a year later to work as an assistant resident at Vanderbilt, and then returned to Boston to work as a resident and research fellow in the laboratory of Dr. James Gamble supervised by Dr. William Wallace. Two years later he moved to New Haven where he worked under another great physiologist, Dr. Daniel Darrow. While working in Dr. Gamble’s lab, Mac and Dr. Wallace built one of the earliest flame photometers, which allowed them to determine sodium and potassium concentrations much more rapidly than by previous methods. Major questions at that time dealt with the ionic composition of body fluid compartments and their defense in the face of major physiologic perturbations. Mac’s early papers demonstrate the collaborative spirit that marked his work and he published multiple papers in with other later luminaries such as Robert Winters, Ernest Cotlove, Lou Welt, Jean Oliver and Robert Schwartz.

Mac’s first academic position was at Indiana University where in 1957, in collaboration with Dr. William Segar, they published perhaps their most widely known paper, “The maintenance need for water in parenteral fluid therapy.” While the data utilized had been published previously, this paper was original in its comprehensive synthesis of energy and fluid requirements throughout the pediatric age range. They derived a formula for maintenance energy and fluid requirements, “100/50/20,” which has stood the test of time and is still used by all who care for children. The concept behind the paper, the integration of whole body physiology, would be a hallmark of Mac’s approach throughout his career.

In 1956 he was recruited by the University of Pittsburgh to head their nephrology section. While there, he was granted a prestigious Career Research Investigator Award. These awards were United States Public Health Service lifetime research awards, which are no longer available, were granted to individual investigators so long as they remained at their original institution. While in Pittsburgh, with summers spent a the Brookhaven Laboratory, Mac’s interest continued to be in the field of fluid and electrolyte therapy; publishing papers in journals as diverse as Pediatrics and Journal of Pediatrics, Journal of Experimental Medicine, Nature and American Journal of Physiology.

In 1963 Mac, Millie and their 5 children moved to the West Coast when he accepted the position of Physician-In-Chief and Head of Research at Oakland Children’s Hospital. Forward looking as always, he worked hard to affect a merger between Oakland Children’s Hospital with the University of California, but was unsuccessful. Several years later he was asked to take over as Chief of Pediatric Nephrology at the University of California, San Francisco, a position he held for the next 27 years. There he turned his attention to the physiologic problems associated with chronic kidney disease, particularly the growth failure seen in children with this condition. In a string of papers and presentations over the next 10-15 years he demonstrated that growth failure was associated with decreased nutritional intake and that growth could be improved with caloric supplementation. He also performed laboratory studies that demonstrated that uremia was associated with abnormalities of protein turnover; studies that were later validated and extended by multiple other investigators. While nutritional supplementation is now one of the mainstays of care, it should be remembered that at the time the concept was not widely accepted. Mac also introduced the use of standard deviation scores as the appropriate reporting method for growth parameters in children with chronic kidney disease.

Outside of the clinic and laboratory Mac was a force in the development of the pediatric nephrology itself. When the decision was made to develop Pediatric Nephrology as a formal subspecialty, Mac was one of three pediatric nephrologists asked to take the Internal Medicine nephrology board examination and then write the first pediatric board exam. Along with Martin Barrett, he took over the editorship of the principal pediatric nephrology textbook, Pediatric Nephrology and his view of integrative physiology that still informs the text today.

Active even after his retirement, Mac and Millie moved to Point Reyes where he served on the Board of Directors of the local health clinic, hiked the lovely pacific seashore, and welcomed frequent guests and colleagues. Mac’s later years were limited by progressive muscle weakness but his intellect and curiosity remained sharp up to the end. Mac published his last paper, a review of fluid therapy, in 2007 at age 83. He was an avid reader, particularly of American History and conversations with him often led to discussions of Lincoln, Jefferson and other American presidents.

During the two and a half decades that he led the nephrology program in San Francisco; his division was prominent as a center for the care of children with chronic kidney disease and a destination for a large number of trainees and visiting professors. Mac had a superb intellect and an inventive mind. He was a rigorous scientist who was always willing to reexamine accepted dogma in the face of new data.

Mac was unfailingly polite and personally quite modest. He was much more interested in the scientific quality of the work to be done rather than the credit attached to it, and was exceedingly generous with his time to both students and colleagues. Malcolm Holliday was a member of that great post-war generation of medical physiologists whose work so expanded our understanding of renal and integrative physiology. Both as a scientist and a person, he touched many of us. All who knew him mourn our loss.

Steven J. Wassner, MD
Distinguished Educator
Professor of Pediatrics, Chief Division of Pediatric Nephrology and Hypertension
Penn State Hershey Children’s Hospital
Penn State University College of Medicine

Richard Louis Siegler, MD (2014)

May 5, 1939 – March 22, 2014

Richard L. Siegler, 74, of Davis California, died peacefully at his home March 22, 2014, after a long battle with cancer. Dick pursued a career helping children, specializing in pediatric nephrology. He established the division of pediatric nephrology and the pediatric dialysis unit at the University of Utah, which continues to serve the entire Intermountain West region. For more than 30 years he shared his medical expertise, personal strength, humor, and commitment to quality with peers, patients and their families. He was recognized as one of the world’s experts in post-diarrheal hemolytic-uremic syndrome (HUS), publishing seminal articles on both short-term prognostic indicators and long-term complications of the disease. After retiring from the University of Utah he continued to contribute to the health of children through his work in Guatemala, where he was honored by the President of Guatemala at the opening of the Richard L. Siegler Pediatric Hemodialysis Center, the first such center in the country. Dick loved adventure, travel, and the outdoors, and once came to work battered and bruised, having become the oldest person to navigate the Olympic luge track in Park City, Utah. Dick was an accomplished violinist and was a member of the Wasatch Symphony Orchestra for many years. Dick was a true character in the best sense of the word, and he will be greatly missed. In lieu of flowers, his family suggests  donations to Bridge of Life, DaVita Medical Missions – Guatemala Project (www.bridgeoflifemm.org/our-missions/guatemala/).

His obituary is posted at:  http://www.legacy.com/obituaries/saltlaketribune/obituary.cfmx?n=richard-louis-siegler&pid=170366924#sthash.eO4nxP79.dpuf