A consultant nephrologist in Newcastle and latterly, Toronto, Robert Uldall had three outstanding qualities – honesty, enthusiasm and dedication. He was born in Lallaguda, Hyderabad, and educated at Shaikh Bagh School, Srinagar, Hillbrow, Sedbergh and the University of Durham. After a short term commission in the Army he completed his training in general medicine and nephrology at the Royal Victoria Infirmary, Newcastle upon Tyne, Dryburn Hospital, Durham and the Colorado Medical Centre, where he spent a year working with Tom Starzl in his pioneering centre for renal transplant. From 1968 to 1975 he was a consultant nephrologist to the Newcastle General and Dryburn Hospitals. He was invited to spend a year at the Toronto Western Hospital in 1975 and stayed on as a member of staff until 1992, as director of haemodialysis. In 1992 he was invited to the directorship of the renal unit at Wellesley and Riverdale Hospitals, Toronto. He was associate professor at the University of Toronto from 1975 to 1995 and had been nominated for promotion to full professor when he died. His booming voice easily penetrated the walls of out-patients, showing his colleagues how he inspired confidence in patients. His commitment to them was total; they had his home number and could call him at any time. For a year after he emigrated to Canada I was asked repeatedly “will he no come back again?”. He was an innovative therapist; throughout his career he inserted the shunts and created the arteriovenous fistulas for haemodialysis when nearly all other nephrologists had ceded the task to vascular surgeons, using his modification of the Gentile technique with an unsurpassable success rate. Occasionally he was carried away by his enthusiasm. Having pioneered the use of cyclophosphamide in minimal change disease in adults he applied it to other forms of nephritis, with less success, but was soon persuaded to set up a controlled trial and readily accepted its negative verdict. He was one of the first to report the drug’s adverse effect on the gonads.
He made many other important contributions to nephrology. He and Ralph Keeler in Newcastle first showed that canine kidneys preserved for transplantation lost intracellular electrolytes and survived longer if perfused with a solution with a higher potassium and magnesium concentration than extracellular fluid – similar to the fluid later introduced in man by Collins and universally known – perhaps a little unfairly – as ‘Collins solution’. For this he gained his distinction in his MD. On return to Newcastle he was a leading medical influence on renal transplantation. With Pat Dewar, Ross Taylor and others he found that blood transfusion enhanced the survival of transplanted kidneys; they made the discovery before Opelz, but sadly their paper was delayed for a year in press and appeared after Opelz’.
Uldall is best remembered today for his work on blood access for haemodialysis. He popularized percutaneous subclavian and jugular catheters and showed how to avoid their complications. His last invention was the soft double lumen silastic catheter which could be inserted percutaneously through a peel-away cannula. He used this reliable form of access to revive nocturnal home haemodialysis for the Ontario Ministry of Health and achieved such initial success that the programme is likely to continue even without his leadership.
He was devoted to his wife, Shirley, his son Richard and his daughter Sarah. After a life time of unclouded enjoyment of his work and social life, he was struck in the last few months by a severe depression and died by suicide shortly after he returned from a trip to Britain for his daughter’s wedding. Shirley never recovered from the shock and died a few months later – a very sad postscript to his life of service and achievement.
