Robert Heptinstall, known to all his friends and colleagues as ‘Heppy’, was a giant in the field of renal pathology and among its leaders from the inception of the specialty in the 1950s onwards.

Robert Hodgson Heptinstall was born in 1920 in Keswick, Cumbria. He graduated from Charing Cross Hospital Medical School, and initially planned to train in surgery, but soon found himself serving in south east Asia in the RAMC in the Second World War. Returning to London he shifted his focus from surgery to pathology moving to St. Mary’s Hospital, London where he was in due course appointed as consultant pathologist. He became interested in the kidney in the early 1950s at a time when research into renal pathophysiology was widespread but clinical renal pathology was only just emerging, notably in the wake of percutaneous renal biopsy becoming a widespread technique.

In 1954 he went to Johns Hopkins Medical School in Baltimore on an MRC fellowship to study hypertension and atherosclerosis, and returned to St. Mary’s working with George Pickering on malignant hypertension. In 1960 he decided to move permanently to the United States, and was soon appointed to the faculty at Johns Hopkins where he remained for the rest of his career, serving as chair of its pathology department from 1969 for almost 20 years.

His report in 1959 with AM Joekes[1] on 136 renal biopsies, among the first biopsies performed in the UK, was highly influential in defining the field of modern clinical renal pathology. He was also an active investigator who made seminal contributions in the fields of hypertension and atherosclerosis, as well as experimental pyelonephritis.

He was always an active teacher and mentor, and he realised the lack of a defining text to present the principles and practice of renal pathology. His response was ‘the Pathology of the Kidney’ first published in 1966, a masterwork which became the prime reference in the field. He wrote the entire first edition and large parts of the subsequent three editions. Although now a multiauthor book with many subsequent editions it continues simply to be known as ‘Heptinstall’. It has maintained its position as the definitive book in the field and continues to be found on the shelves of pathology departments all over the world.

Heppy was a giant in his field who mentored and influenced many who became in turn its leaders. As well as his academic and clinical work he developed the profile of renal pathology through his leadership roles in the International Society of Nephrology (ISN) and as President of the American Society of Nephrology. He was one of the founders of the Renal Pathology Society (RPS), serving as its president from 1980 to 1983. Among many recognitions he received the Jean Hamburger Award and a Lifetime Achievement Award from RPS; the latter presented to him at his home in Baltimore in his 91st year, an occasion notable for Heppy’s undiminished wit, charm and intelligence.

[1] Heptinstall RH, Joekes AM. Proc Roy Soc Med 1959; 52:211