Martin Barratt

Thomas Martin Barratt (13 February 1936 – 17 January 2014) was a British paediatrician and professor of paediatric nephrology. Barratt was most notable for developing a specialist service for children with kidney diseases in Britain, bringing peritoneal dialysis, haemodialysis, and later renal transplantation to ever younger children. Barratt was an early advocate for multidisciplinary care and developed a model that was later taken up by many other specialist centres across the world. His research led to a new treatments for many types of childhood kidney diseases., and for research into childhood Nephrotic syndrome and Hemolytic-uremic syndrome.

Life
Barratt's father owned and ran a law firm, and his mother was one of the first women to matriculate at Cambridge University. He was the third of three children. Barratt's early schooling took place at Clifton College and after winning a scholarship to Trinity Hall, Cambridge, he graduated with a First-class honours in Natural Sciences.

Throughout his life, Barratt suffered from facioscapulohumeral muscular dystrophy, a disease that causes progressive weakness, which forced him to retire early, eventually forcing him to use wheelchair for movement. In retirement he kept up to date with the latest developments in paediatric nephrology.

Career
Barratt completed his clinical training at St Thomas' medical school. After a number of house positions, he was appointed as a registrar at the Institute of Child Health, at Great Ormond Street Hospital, working with Professor Barbara Clayton. Barratt then spent a year as a research fellow at Johns Hopkins School of Medicine, Baltimore, working within the Department pharmacology and experimental therapeutics, and researching fluid physiology with Mackenzie Walser. Upon returning to the UK in 1967, Barratt was appointed as a lecturer working on paediatric nephrology with Professor John Soothill at the institute. In 1971, Barratt was promoted to senior lecturer in the Institute of Child Health and consultant paediatric nephrologist at Great Ormond Street Hospital for Children and in 1978 promoted to professor of paediatric nephrology.

In 1966 Barratt married Gill Owen, a social worker who was later promoted to group analyst and psychotherapist.

Research
When Barratt started his clinical career, the specialism of paediatric nephrology in the UK, outwith certain areas, was primitive. Barratt held the first post that was specifically committed, both academically and professionally to the treatment of children with renal disease.

Barratt initially worked by himself, but was joined by Michael Dillon in 1975, and together they built a major world class paediatric nephrology services department at Great Ormond Street Hospital and conducted a research programme at the Institute of Child Health. Barratt was later joined by Richard Trompeter and Lesley Rees who continued the work of Barratt.

Barratt early in his career realized that collaboration was needed in developing an interdisciplinary care model for the treatment of children with renal diseases, eventually working closely with the paediatric urologists David Innes Williams and Philip G. Ransley and the paediatric imager, Isky Gordon.

Barratt had a broad research focus, conducting research into GFR measurement, urolithiasis, renal cystic disease, Diabetes mellitus, kidney disorders, renal function after cardiopulmonary bypass, genetic studies in inherited kidney disorders and the urological disorders in children. It was research into childhood Nephrotic syndrome and the Hemolytic-uremic syndrome that was his most notable work, particularly the biological roles played by atopy, membrane charge and Cytokine release. Barratt undertook a number of trials to determine the best treatments with patients with nephrotic symptoms. In 1970, Barratt conducted a trial with the immunologist John Soothill, using cyclophosphamide treatment for nephrotic syndrome. Barratt tested the drugs Azathioprine, Levamisole and cyclosporine A in subsequent trials, eventually working with paediatrician Michael Levin and others to study pathogenetic mechanisms involved in the syndrome, including e.g. Platelet-derived growth factor and prostacyclin inhibition. Levin who was Barratt's registrar at Great Ormond Street stated of Barratt, that:


 * Clinically, Martin had the most wonderful clarity of thought—making the most complex issues clear. He had an absolute belief that the job of a consultant was to offer patients the best of all available evidence.

Barratt was considered an outstanding teacher and lecturer.

Association work
From 1972 to 1976, Barratt was secretary of the British Association for Paediatric Nephrology, and from 1994 to 1997 he was president of the association. Barratt worked with the European Society for Paediatric Nephrology and the International Pediatric Nephrology Association. After his retirement, in 1998, Barratt was co-president along with the paediatrician Sir Cyril Chantler of the 11th Congress of the International Pediatric Nephrology Association.

Awards and honours
In 1997 Barratt was appointed Commander of the Order of the British Empire (CBE) for services to children and awarded the prestigious James Spence Medal in 2002.