As a bright young doctor at Guy’s hospital in London in the 1960s, Stewart Cameron, who has died aged 89, was determined to be both clinician and researcher, but where should he focus his talents? Irreversible kidney failure – uniformly fatal until then – was just becoming treatable through dialysis or kidney transplantation; both were complex, demanding and dangerous, for patients and doctors alike.
Stewart had found his metier and decided to make renal medicine his life’s work. The first professor of renal medicine in the UK, he created at Guy’s a unit that became internationally known for its research and treatment of kidney failure.
He realised that any unit offering only dialysis would soon be overwhelmed unless kidney transplantation was also available. So from the mid-60s – with his close colleague Chisholm Ogg – he established a combined service.
His socialist principles were reflected in his egalitarian approach: there was to be equal access to treatment for all in need, and collaborative team work was the watchword. All were partners – patients and staff alike. Nurses and other staff knew they were respected members of the team and responded to the responsibility and autonomy they were given. Unconventionally, first names were the norm.
Their success meant referrals flooded in. They were treating both children and adults until a paediatrician, Cyril Chantler, joined them. The challenges were exciting and they were working full tilt, but there was a price. There was a hepatitis B outbreak in the unit in 1969, and Stewart himself was severely ill. The unit recovered and flourished, becoming a beacon, attracting streams of trainees and visitors.
He was determined that research would be fostered despite the clinical workload. He was a walking textbook of nephrology, but it was the study of nephritis, immune-mediated kidney disease, that he focused on.
Following in the tradition of Richard Bright, the 19th-century Guy’s physician, Stewart recognised the value of longitudinal study of personally observed cases. Combining this with the study of kidney tissue obtained by biopsy, he separated all the known types of nephritis into precisely defined groups and pinpointed their differing natural histories.
He introduced to nephrology the now standard statistical method (the Kaplan-Meier plot) that enabled him to compare groups, identify factors that influenced outcome (such as the amount of protein leaking into the urine), and evaluate novel treatments. He wrote a large number of clear authoritative papers, books and book chapters that transformed thinking about nephritis and its treatment. He was a commanding teacher, filling lecture theatres and stimulating challenge and debate.
Stewart’s skills meant he was soon drawn into leadership in the kidney world beyond Guy’s – nationally then internationally. He was articulate and forceful in his espousal of the need for more resources for kidney treatment in the UK; this was not popular in the Department of Health. He served as president of the UK Renal Association (1992-95), the European Renal Association (1985-1988) and the International Society of Nephrology (1993-95).
His international leadership was not just titular; he travelled the world teaching in many different settings, especially encouraging the emergence of nephrology in developing countries. With his gift for friendship and his unrelenting energy, he was a much-loved mentor to hundreds of nephrologists, many of whom came from abroad to Guy’s and then returned to their own countries.
He was born in Aberdeen, to John Cameron, who was in the merchant navy, and Ethel (nee Lawrence), a secretary. The family moved to London in 1946, and Stewart went to Ealing grammar school before studying at Guy’s Hospital medical school, graduating in 1959. After a Fulbright scholarship in New York, he returned to Guy’s in 1963.
He did not at first fit into Guy’s. He had married Margot Manley in 1956 and had two children while still a medical student. A grammar school boy with a preference for contemporary clothes and hairstyle, he was quite unlike the typical London teaching hospital consultant of the day. But his brilliance and achievements persuaded the doubters. In 1974 he was made professor of renal medicine.
Chantler described Stewart as “the most curiously intelligent doctor I have ever known. We used to say at Guy’s if you wanted to know something about anything you had to go the library … or better still … ask Stewart.” He was a multilingual polymath, and knew more than most of us about everything – certainly nephrology, but equally Keats, rock climbing, Gaelic poetry and history. However, Stewart will be best remembered for his lack of self-importance, and his enthusiasm for the work of others.
When still at the height of his powers, he was forced by illness to retire early from clinical and academic work, in 1996. He was appointed CBE in 1998 for services to nephrology.
He retired to Cumbria and to Mull, and continued to write about his many interests, for example a history of the Ross of Mull.
When Margot developed dementia, he cared for her at home until her death. He later found happiness with Alison Russell, whom he met again 40 years after she had been a ward sister at Guy’s. In 1971 they had written the first nursing book on the treatment of renal diseases. They married in 2018.
A son, Ewen, predeceased him in 2013. He is survived by Alison, his daughter, Sheena, and a granddaughter, Laura.