HA Lecture: RD Wright I A/Prof Jens Titze
| Wednesday, December 10, 2025 |
| 5:15 PM - 5:45 PM |
| Hall C Lower Section |
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Sponsored By:
Ja Davey
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Details
The “salt equation” taught to medical doctors for more than 150 years is not difficult to understand. The body relies on this essential mineral for various functions, including blood pressure regulation and the transmission of nerve impulses. Consequently, sodium levels in the body must be carefully maintained within narrow physiological ranges. When we consume a lot of salt (sodium chloride) we become thirsty and drink water, diluting our blood to maintain the proper concentration of sodium. Ultimately, we will excrete much of the excess salt and water in the urine and reach a “steady state” of body Na+. This theory is intuitive and simple, but most likely incorrect.
We will first discuss how sodium and potassium hydrate the total body water space (first 5 min). We will then interpret experimental data showing that salt-sensitive hypertension initiates with potassium-driven dehydration of the intracellular volume space (second 5 min). We will then interpret data showing that sodium retention in (salt-sensitive) hypertension serves to re-hydrate the body water space back to normal and compare salt-sensitive with renal hypertension (third 5 min).
After half-time, we will discuss the physiological implications of interpreting salt-sensitive hypertension as a disease of potassium-driven intracellular volume shrinkage, and not as a disease of sodium-driven extracellular volume overload (fourth 5 min). We will then discuss non-invasive magnetic resonance imaging for transfer of these insights into the clinical arena (fifth 5 min).
We will finally discuss the promising success of potassium-enriched table salt supplements for disease prevention from a more mechanistic point of view (last 5 min).
Speaker
A/Prof Jens Titze
DukeNUS Medical School
Body fluids and blood pressure: lost in translation
Biography
I began working on salt and water homeostasis as a medical student in 1991. At that time, the generally accepted belief was that body Na+ content is constant, and that any increase would elevate blood pressure. Measuring Na+ balance in humans preparing for long-term space missions, however, we found that rhythmically Na+ dis- and re-appeared from an at that time invisible storage site.
Developing novel tools, we saw that rodents and humans store large amounts of Na+ under their skin and in skeletal muscle, and that the storage process is physiologically regulated. This new way of thinking about the body fluids quickly delivered new research avenues in immunology (immunological host defence and auto-immunity), endocrinology (insulin resistance, diabetes mellitus, and metabolic muscle function), and cardiovascular disease (hypertension research, heart failure).
Today, our clinical research revolves around the fact that Na+ storage is secondary to intracellular K+ depletion, and that increasing K+ intake effectively reverses this process; with beneficial effects on blood pressure. In the basic research arena, we dream of solving a general methodological-physiological root problem in the field: our inability to visualize and quantify Na+ and K+ distribution disorders inside diseased cells at the µm scale in intact, hydrated organs.
Chair
Markus Schlaich
Dobney Chair In Clinical Research
Royal Perth Hospital - University of Western Australia
