Professor Dr Eberhard Ritz was a towering figure in European nephrology, a clinician, a scientist and educator. He was an Honorary Member of the Renal Association.
He was born in Heidelberg in 1938. His father, Robert, was a tax official and his mother, Juliana, a nurse. He was an anglophile despite his first encounter with the British, when he was six years old, being an attack by the RAF on the street on which he was walking with his mother. He spent his early years in Heidelberg and in Lindach, Germany and latterly in Erlach, Switzerland. In 1957 he returned to Heidelberg for undergraduate studies graduating in 1963 having also spent some time in the medical schools of Munich and Montpellier. As the recipient of the scholarship ‘Studienstiftung des Deutschen Volkes’ he began his first clinical appointment in the Department of Internal Medicine in Zurich under the supervision of Professor Walter Siegenthaler. In 1966, as was common for those wishing to pursue academic medicine, he travelled to the USA for a National Institutes of Health Post Doctoral Fellowship in the Department of Biochemistry, Washington University, St Louis with Professor J E Kirk where he studied the pentose cycle and the metabolism of acid mucopolysaccharides in experimental atherosclerosis. In 1967 he returned to Heidelberg to an appointment in the Department of Internal Medicine of the Ruperto Carola University where he was instructed to establish a dialysis unit to support the newly established renal transplant programme. From 1970 until he retired in 2003 he was in charge of the Renal Division of the Department of Internal Medicine. He was appointed as an Associate Professor in 1972 and full Professor of Internal Medicine in 1974.
The experience he gained in the United States engendered a lifelong interest in cardiovascular disease and, in particular, its relationship to renal disease – its effect on chronic kidney disease and vice versa. He researched the roles of hypertension, sodium intake, diabetes mellitus and smoking as risk factors for progression and was one of the earliest proponents of strict blood pressure control to reduce deterioration in renal function. Renal osteodystrophy was a particularly severe problem in the early days of dialysis therapy and he researched the factors responsible, in particular Vitamin D and phosphate homeostasis. He was also interested in the mechanics of haemodialysis including the role of water quality, use of bicarbonate buffer, spallation of silicone particles from PVC tubing and the differences between haemodialysis and haemodiafiltration. With his colleague Jurgen Bommer he established a training centre for home haemodialysis.
He cared assiduously about the wellbeing of his patients. He spoke to them in easily understood terms and in outpatient clinics would dictate his letters in their presence to ensure they knew the opinion he was offering. The majority of his many publications related to improvement in clinical care. He was a remarkable physician who combined clinical science, technological innovation and patient care.
He greatly enjoyed teaching. In 1976 he established the Heidelberg Nephrology Seminars which encompassed developments in renal physiology, problems in clinical nephrology and case discussions to illustrate particular clinical problems. He invited internationally renowned nephrologists to present updates. He made it possible for junior doctors, particularly from Eastern Europe, to attend. This was at a time when east-west travel in Europe was difficult, and he would often find the money to enable such trainees to attend. He also established an annual post-graduate training course in Prague. After the end of the Cold War he reached out to the former Eastern Bloc countries offering to provide teaching seminars in their larger cities delivered by senior international experts. If he invited you to join the “faculty” it was virtually impossible to say no. His wife was from East Germany so he had first-hand experience of the lack educational opportunities.
He was the author of several hundred journal articles and numerous book chapters as he was a recognised authority in so many areas. He had an extensive knowledge of the literature in many fields and languages. He told his British friends that before boasting of the first description of anything they should learn to speak German. He had a particular skill in sifting newly published work and distilling the core message. He was the Editor in Chief of the major European journal Nephrology Dialysis Transplantation from 1993 to 1999. During this time the journal content increased because of his wish to encourage as many authors as possible to contribute. For many this would be their first submission for publication so he would offer helpful editorial advice, sometimes virtually rewriting the submission. He was a founder Editor of the Oxford Textbook of Clinical Nephrology and took charge of the section on chronic kidney disease for the first three editions. He had a strong work ethic and was known, while on long flights to overseas meetings, to have a routine of working on manuscripts for an hour, then sleeping for an hour.
He was an imposing figure whom even his peers found formidable. Once when he was a visiting professor at the Hammersmith Hospital, it was realised that nothing had been arranged for one of the evenings. All the consultants were committed so the senior registrar was told to entertain him; his wife offered with four hours’ notice to prepare dinner. Eberhard was a charming guest who clearly enjoyed the company of the younger generation and the next morning a huge bunch of roses arrived on the doorstep.
Many national and international societies recognised his extraordinary abilities and awarded him honorary membership. He received honorary doctorates from universities in Poland, Hungary and Romania. He was invited to give many named lectures worldwide. His expertise and wisdom were well recognised and as a result he played a significant part in national and international organisations. He was a Council Member of the European Renal Association, the Gesellschaft fur Nephrologie, the European Society of Paediatric Nephrology, the European Research Association and was President of the International Society of Nephrology from 2007 to 2009. The successful ISN meeting held during his Presidency was the best ever attended, with more than 10,000 delegates. He was elected a Fellow of the Royal College of Physicians in London in 1992. The same year 1992 he delivered the Sir Michael Perrin Lecture on Vitamin D metabolism in renal failure and in 2003 the Lilly Lecture on Renal dysfunction – a powerful cardiovascular risk factor. He was also awarded the Fellowship of the Royal College of Physicians of Edinburgh.
Eberhard Ritz was a polymath and scholar with an eclectic range of interests. He was fluent in French, English and Italian and had a working knowledge of Polish and Russian. He would take a dictionary on holiday to extend his knowledge of a particular language by spending some time each morning looking up new words and phrases. In addition, in spite of his demanding work, he was a dedicated family man. In 1975 he married Dr Christina Kirschner, a paediatric general practitioner, who supported him greatly in his clinical and academic work. They had four children to whom he was devoted and whose careers he delighted in following. He died in Heidelberg in October 2023 following a long and debilitating illness during which Christina and his family provided unstinting support. It was cruel fate that his illness gradually deprived him of the memory which had served him so well in his professional and social life.