Ammonia In Exhaled Breath Research Articles

Photoionization ion mobility analyzer for on-site measurement of exhaled acetone by coupling miniature thermoelectric cooling dehydration

The breath concentration of acetone holds significant clinical importance, the development of on-site and accurate analyzer for exhaled acetone is highly demanded. A photoionization ion mobility analyzer based on a low-pressure krypton discharge lamp has been developed for direct and rapid determination of the acetone concentration. The difficulty for sensitive measurement of acetone by vacuum ultraviolet photoionization was the strong absorption of water molecules in the breath air. An online dehydration device with a miniature thermoelectric cooling quartz trap has been developed, which was capable for reducing the relative humidity from over 90 % to below 1 %. The dehydration could enhance the signal intensity of acetone about 85 times. The response time of current thermoelectric cooling dehydration was only 1/20 of the Nafion tube dehydration. A limit of detection 0.02 ppmV and linear response up to 2.0 ppmV were achieved. The interferences from ammonia in exhaled breath was eliminated using a calibration method based on ion number density, achieving recoveries ranging from 90 % to 110 %. In the final, the variation trends of exhaled acetone level in healthy individuals following the ingestion of glucose under fasting conditions were carried out to demonstrate the potential application of the analyzer.

Optical chemical gas sensor based on spectral autocorrelation: A method for online detection of nitric oxide and ammonia in exhaled breath

The detection of nitric oxide (NO) and ammonia (NH3) in exhaled breath (EB) plays a crucial role in non-invasive diagnosis of airway inflammatory and kidney diseases. Here we report an optical chemical gas sensor for NO and NH3 based on spectral autocorrelation. In our sensor system, the target gas is removed through a chemical reaction with a sensing material and the spectrum of the target gas is extracted from the spectra obtained before and after the reaction by autocorrelation. Our method focuses on the ability of the material to eliminate the target gas without the need for detecting signals of the reaction, greatly relaxing the requirements on material properties. Fundamentally different from optical sensors that obtain spectra by spectral decoupling, our sensor relies on autocorrelation operation to acquire the spectrum of the target gas, thereby overcoming spectra overlap. Lab-based results show that the sensor enables detection of NO (2.28–451.82 ppb) and NH3 (11.52–12,725.42 ppb) with mean absolute errors (MAEs) of 0.79 ppb and 6.13 ppb and measurement accuracies of 0.8 % and 1.4 %, respectively. The EB experiment proves that the sensor can detect exhaled NO and NH3 and distinguish EB between healthy subjects and simulated patients.

Development of a pH‐strip‐based sensor for the detection of ammonia in exhaled breath as a promising method for the diagnosis of Helicobacter pylori infections

Development of a <scp>pH</scp>‐strip‐based sensor for the detection of ammonia in exhaled breath as a promising method for the diagnosis of <i>Helicobacter pylori</i> infections

CNN-CatBoost ensemble deep learning model for enhanced disease detection and classification of kidney disease

An efficient deep-learning prediction model for identifying chronic kidney disease (CKD) from exhaled breath is presented in this paper. The concentration of urea will be higher in CKD patients. Salivary urease breaks down the stored urea into ammonia, which is then excreted through breath. Thus, by monitoring the breath ammonia content, it is possible to identify the presence of high urea levels in the body. In this work, a novel sensing module is developed and applied to measure and assess the amount of ammonia in exhaled breath. Moreover, an effective deep learning prediction model that combines the CatBoost algorithm and convolutional neural network (CNN) is used to automate the prediction of disease. The proposed model, which combines the benefits of gradient-boosting and CNN, attained an exceptional accuracy of 98.37%. Experiments are conducted to evaluate the proposed model using real-time data and to assess how well it performs in comparison with existing deep learning methods. Our study's findings demonstrate that kidney disease can be accurately and noninvasively diagnosed using the proposed approach.

Rapid fluorometric determination of ammonium in exhaled breath condensate based on digital image of a windowless falling drop cell via a low-cost digital microscope

Measurement of ammonia in exhaled breath is of interest in medical and health sciences. The fluorometric determination of NH3 in exhaled breath condensate (EBC) was developed based on a digital image of a windowless falling drop (WFD) cell at the end of tube via a sensitive and selective reaction of NH3-OPA-sulfite in flow injection analysis system (FIA). A low-cost USB microscope as a facile instrumentation without expensive optical parts, an amplifier circuit, and a data acquisition unit, was used as a fluorescence light detector for the WFD cell via instant reporting temporal profile of digital value. A linear calibration graph of NH4+ in the range of 0.5–10 µmol L−1 can be obtained with a limit of detection of 0.5 µmol L−1 NH4+, and repeatability of 5.5% RSD (n = 11). The fluorescence (FL) signal obtained from the low-cost USB microscope was not different from that using the photodiode detector via a cross-shape flow cell. The proposed device was successfully applied for NH4+ determination in EBC and air absorbing solution samples with the recovery of 98–110%. The approach for instant reporting of a temporal profile of digital image value from a camera shows a potential to be applied for rapid chemical analysis in other microfluidics systems.

Design and Fabrication of a Gas Sensor Based on a Polypyrrole/Silver Nanoparticle Film for the Detection of Ammonia in Exhaled Breath of COVID-19 Patients Suffering from Acute Kidney Injury.

One of the serious complications of COVID-19 is acute kidney injury (AKI), leading to a decrease in kidney function and even death. The concentration of ammonia (NH3) in the exhaled breath (EB) of COVID-19 patients suffering from AKI symptoms will be significantly increased. In this work, the detection of breath NH3 was performed at gold interdigital electrodes modified with a soluble polypyrrole microparticle and silver nanoparticle film (Au-IDEs/S-PPyMPs/AgNPs) as a noninvasive chemiresistor gas sensor. The response behavior of unmodified and modified gas sensors toward NH3 and other interfering compounds was studied. The Au-IDEs/S-PPyMPs/AgNPs exhibited NH3 detection in the linear dynamic range of 1.00-19.23 ppm, with a limit of detection of 0.12 ppm. Finally, the fabricated gas sensor was used to monitor the NH3 concentration in the EB of COVID-19 patients suffering from AKI symptoms. For this purpose, the gas sensor was validated in 19 EB samples (seven COVID-19-positive patients, four COVID-19-negative patients, and eight post-COVID-19 patients). The gas sensor was directly exposed to the EB samples, followed by recording the changes in electrical resistance via a low-cost digital multimeter. The sensing mechanism was explained as the interaction between breath NH3 and sensing materials. The breath NH3 concentrations have a desirable correlation (R2 = 0.8463) with the estimated glomerular filtration rate (eGFR) values in COVID-19-positive patients. The fabricated gas sensor can distinguish COVID-19-positive patients suffering from AKI symptoms from COVID-19-negative patients and post-COVID-19 patients. The present work can pave the way for the development of a simple and efficient analytical approach for COVID-19 patients with AKI without the need for sample pretreatment.

A Preliminary Study for Tunable Optical Assessment of Exhaled Breath Ammonia Based on Ultrathin Tetrakis(4-sulfophenyl)porphine Nanoassembled Films

The detection of chemical substances excreted from the human body offers an attractive approach for non-invasive, early diagnostics of certain diseases. In this preliminary study, we proposed a susceptible optical sensor capable of quantitatively detecting ammonia from exhaled breath. The proposed sensor consists of nanoassembled ultrathin films composed of tetrakis(4-sulfophenyl)porphine (TSPP) and poly(diallyldimethylammonium chloride) (PDDA) deposited on quartz substrates using a layer-by-layer method. Measurement principles are based on the ammonia-induced absorbance changes at 489 (Soret band) and 702 nm (Q band), associated with the deprotonation of the J-aggregated TSPPs inside the film. Before exposure to breath, the PDDA/TSPP thin film was calibrated using known concentrations of ammonia gases with a projected detection limit of 102 ± 12 parts per billion (ppb). Calibrated sensor films were then exposed to human breath and urine samples to determine the ammonia concentration. Concentrations of exhaled ammonia are influenced significantly by the consumption of food or the amount of urea. Sensor response and maximum sensitivity, obtained from the absorbance changes induced by ammonia, were achieved by initial sensor exposure to HCl vapor. Previously reported procedures for the Helicobacter pylori (HELIC Ammonia Breath) test based on urea reaction with urease were reproduced using the proposed sensor. The observed behavior corresponded very well with the kinetics of the interactions between urea and urease, i.e., ammonia reached a maximum concentration approximately 5 min after the start of the reaction. A large-scale study involving 41 healthy volunteers in their 20s to 60s was successfully conducted to test the capabilities of the sensor to determine the concentration of exhaled ammonia. The concentration of ammonia for the healthy volunteers ranged between 0.3 and 1.5 ppm, with a mean value of ca. 520 ppb in the morning (before eating) and ca. 420 ppb in the afternoon (immediately after eating). These real-test mean values are meaningful when considered against the projected LOD.

Real-time breath ammonia measurement using a novel cuprous bromide sensor device in patients with chronic liver disease: a feasibility and pilot study

We developed a small portable sensor device using a p-type semiconductor cuprous bromide (CuBr) thin film to measure breath ammonia in real time with highsensitivity and selectivity. Breath ammonia is reportedly associated with chronic liver disease (CLD). We aimed to assess the practical utility of the novel CuBr sensor device for exhaled breath ammonia and the correlation between breath and blood ammonia in CLD patients. This was a feasibility and pilot clinical study of 21 CLD patients and 18 healthy volunteers. Breath ammonia was directly and quickly measured using the novel CuBr sensor device and compared with blood ammonia measured at the same time. CLD patients had significantly higher breath ammonia levels than healthy subjects (p = 1.51 × 10−3), with the level of significance being similar to that for blood ammonia levels (p= 0.024). Significant differences were found in breath and blood ammonia between the healthy and cirrhosis groups (p = 2.97 × 10−3 and 3.76 × 10−3, respectively). Significant, positive correlations between breath and blood ammonia were noted in the CLD group (R = 0.747, p = 1.00 × 10−4), healthy/CLD group (R = 0.741, p = 6.75 × 10−8), and cirrhosis group (R = 0.744, p = 9.52 × 10−4). In conclusion, the newly developed, easy-to-use, and small portable CuBr sensor device was able to non-invasively measure breath ammonia in real time. Breath ammonia measured using the device was correlated with blood ammonia and the presence of liver cirrhosis, and might be an alternative surrogate biomarker to blood ammonia.

Breath Ammonia Is a Useful Biomarker Predicting Kidney Function in Chronic Kidney Disease Patients.

Chronic kidney disease (CKD) is a public health problem and its prevalence has increased worldwide; patients are commonly unaware of the condition. The present study aimed to investigate whether exhaled breath ammonia via vertical-channel organic semiconductor (V-OSC) sensor measurement could be used for rapid CKD screening. We enrolled 121 CKD stage 1–5 patients, including 19 stage 1 patients, 26 stage 2 patients, 38 stage 3 patients, 21 stage 4 patients, and 17 stage 5 patients, from July 2019 to January 2020. Demographic and laboratory data were recorded. The exhaled ammonia was collected and rapidly measured by the V-OSC sensor to correlate with kidney function. Results showed no significant difference in age, sex, body weight, hemoglobin, albumin level, and comorbidities in different CKD stage patients. Correlation analysis demonstrated a good correlation between breath ammonia and blood urea nitrogen levels, serum creatinine levels, and estimated glomerular filtration rate (eGFR). Breath ammonia concentration was significantly elevated with increased CKD stage compared with the previous stage (CKD stage 1/2/3/4/5: 636 ± 94; 1020 ± 120; 1943 ± 326; 4421 ± 1042; 12781 ± 1807 ppb, p < 0.05). The receiver operating characteristic curve analysis showed an area under the curve (AUC) of 0.835 (p < 0.0001) for distinguishing CKD stage 1 from other CKD stages at 974 ppb (sensitivity, 69%; specificity, 95%). The AUC was 0.831 (p < 0.0001) for distinguishing between patients with/without eGFR < 60 mL/min/1.73 m2 (cutoff 1187 ppb: sensitivity, 71%; specificity, 78%). At 886 ppb, the sensitivity increased to 80% but the specificity decreased to 69%. This value is suitable for kidney function screening. Breath ammonia detection with V-OSC is a real time, inexpensive, and easy to administer measurement device for screening CKD with reliable diagnostic accuracy.

Humidity-Assisted Highly Selective Ammonia Sensors Based on Nonconjugated Proton-Conductive Polymers

Introduction Analysis of exhaled human breath has great significance for the early non-invasive diagnosis [1]. At present, gas chromatography and mass spectrometry, which can accurately analyze gas composition, are the most common methods used in exhaled breath analysis. However, these methods remain high cost, complex and require the preconcentration of the exhaled breath; thus, the advantages of exhaled breath analysis in medical diagnostics have yet to be realized [2]. Gas sensors are considered as the most promising candidate for exhaled breath analysis due to the advantages of high sensitivity, fast response, low-cost and integratable [3]. However, exhaled breath is a complex environment that is highly humidified (~100% relative humidity (RH)) and is composed of thousands of gases [4]. Poor selectivity and strong humidity influence are two bottlenecks which limit the application of recent gas sensors in exhaled breath analysis.In this work, instead of seeking to avoid the influence of high humidity, a novel method, which utilizes the conductivity change caused by the adsorption, dissolution, ionization and migration processes of ammonia in water to build a proton-conductive gas sensor, is presented for realizing highly sensitive and selective ammonia detection in a humid atmosphere. The mechanism is similar to the humidity sensing of impedance-type devices based on an ionogel. Base on this mechanism, water becomes the functional material that absorbs and ionizes ammonia. To detect trace-level ammonia, a miniscule water layer is required; however, such a water layer is unstable. Hence, a sensitive film that can collect water molecules from the atmosphere and create an aqueous solution-like environment is needed. Compared to the majority of rigid materials, flexible polymers are good at providing a stable aqueous solution-like environment. In the field of gas sensors, semiconductor materials such as metal oxides, conjugated polymers and reduced graphene oxide present clear responses to most of active gases via catalytic redox reactions, which dose not promote a high selectivity. Hence, nonconjugated hydrophilic polymers, which exhibit an excellent capacity for water adsorption and conduct only via the proton conductive channel formed by the adsorbed water, were considered to be the optimal choice to build a highly selective poroton-conductive ammonia sensor of ammonia in a humid atmosphere. This method provides a new potential approach for the analysis of ammonia in exhaled breath.

Sensitive, selective and rapid ammonia-sensing by gold nanoparticle-sensitized V2O5/CuWO4 heterojunctions for exhaled breath analysis

Marigold flower-like V2O5/CuWO4 heterojunctions were synthesized and its volatile organic compound (VOC)-sensing properties were tested and significantly enhanced after sensitizing by Au nanoparticles. Detailed characterizations were carried out by SEM, XRD and XPS to determine the morphology, crystal structure, elemental and chemical composition of the sensing materials, respectively. The fabricated gold-sensitized sensor was found to be rapidly responsive (a few seconds), highly sensitive to ammonia with good selectivity as compared to various types of VOCs. The limit of detection and linear range of sensor at 150 °C were 212 ppb and 5–158 ppm, respectively, which is suitable for detection of exhaled breath ammonia of patients at their last stage of chronic kidney disease. Furthermore, it was found to be of high intra-day repeatability, which is properly explained by discussing the mechanism of NH3 sensing. Very long-term stability of the sensor was investigated over 56 days, once a week.

Indoor air quality (IAQ) evaluation of a Novel Tobacco Vapor (NTV) product

The impact of using a Novel Tobacco Vapor (NTV) product on indoor air quality (IAQ) was simulated using an environmentally-controlled chamber. Three environmental simulations were examined; two non-smoking areas (conference room and dining room) and one ventilated smoking area (smoking lounge). IAQ was evaluated by (i) measuring constituents in the mainstream NTV product emissions, (ii) and by determining classical environmental tobacco smoke (ETS) and representative air quality markers. Analysis of the mainstream emissions revealed that vapor from the NTV product is chemically simpler than cigarette smoke. ETS markers (RSP, UVPM, FPM, solanesol, nicotine, 3-ethenylpyridine), volatile organic compound (toluene), carbon monoxide, propylene glycol, glycerol, and triacetin were below the limit of detection or the limit of quantification in both the non-smoking and smoking environments after using the NTV product. The concentrations of ammonia, carbonyls (formaldehyde, acetaldehyde, and acetone), and total volatile organic compounds were the same levels found in the chamber without NTV use. There was no significant increase in the levels of formaldehyde, acetone or ammonia in exhaled breath following NTV use. In summary, under the simulations tested, the NTV product had no measurable effect on the IAQ, in either non-smoking or smoking areas.

Recent analytical approaches to detect exhaled breath ammonia with special reference to renal patients.

The ammonia odor from the exhaled breath of renal patients is associated with high levels of blood urea nitrogen. Typically, in the liver, ammonia and ammonium ions are converted into urea through the urea cycle. In the case of renal dysfunction, urea is unable to be removed and that causes a buildup of excessive ammonia. As small molecules, ammonia and ammonium ions can be forced into the blood-lung barrier and occur in exhaled breath. Therefore, people with renal failure have an ammonia (fishy) odor in their exhaled breath. Thus, exhaled breath ammonia can be a potential biomarker for monitoring renal diseases during hemodialyis. In this review, we have summarized the source of ammonia in the breath of end-stage renal disease patient, cause of renal disorders, exhaled breath condensate, and breath sampling. Further, various biosensor approaches to detect exhaled ammonia from renal patients and other ammonia systems are also discussed. We conclude with future perspectives, namely colorimetric-based real-time breathing diagnosis of renal failure, which might be useful for prospective studies.

Sensor Data Classification for Renal Dysfunction Patients Using Support Vector Machine

Breath analysis is a non-invasive technique used in clinical laboratories for the identification of several morbid conditions. Renal failure patients can be distinguished by observing the degree of ammonia in exhaled breath. Standard treatment for renal failure patients is haemodialysis. Ammonia as a biomarker can also provide the efficiency of dialysis. This study proposes a system that uses metal oxide semiconductor sensors, which is capable of detecting ammonia from exhaled breath and identify whether the patient has been subjected to renal failure. Breath samples are gathered using a specially designed breath collecting tube and the steady-state responses are recorded after the samples have been passed through sensors TGS2444, MQ135, MQ137, and TGS826. From the steady-state response, geometric features are extracted and the support vector machine technique is used for classifying the pre- and post-dialysis groups. The results shown an accuracy of 88 % for the designed classifier for sensor TGS2444.

A Semiconductor Gas System of Healthcare for Liver Disease Detection Using Ultrathin InN-Based Sensor

The gas sensor based on platinum-catalyzed ultrathin indium nitride (Pt-InN) was used to detect liver disease by sub-ppm ammonia (NH3) concentration variation in an ambient environment simulating exhaled human breath. Because the InN with strong surface electron accumulation extensively enhanced sensitivity, the NH3 gas sensor minimum detection limit is 0.2 ppm. Meanwhile, the sensor enables to distinguish slight deviation in NH3 concentration between 0.2 and 0.8 ppm that brings simple diagnosis of liver disease for portable and homecare clinical applications. Liver cancer is first of the top ten causes of death in Asia. Abnormal concentrations of the breath volatile organic compounds (VOCs) are reported to correlate with unhealthy/injurious body/organ conditions; for instance, ammonia (NH3) gas for renal and liver disease. Therefore, the detection of ammonia concentration in exhaled breath more important. In this study, an indium nitride (InN) gas sensor of 10 nm in thickness has achieved detection limit of 0.2 ppm ammonia. The sensor has a size of 1 mm by 2.5 mm, while its sensing area is 0.25 mm by 2 mm and deposited with a 10 nm thick Pt film on the sensing window to investigate the effect of catalyst on ammonia gas detection, shown in Fig 1. The ultrathin InN epilayer extensively enhances sensing sensitivity due to its strong electron accumulation on roughly 5–10 nm deep layers from the surface. Sensitivity is expected to be much better due to the natural electronic characteristics of as-grown InN films, including a narrow band gap, excellent electron transport characteristics (mobility > 1,000 cm2·V·s), a background high electron density (typically in excess of 1 × 1018 cm-3), and the unusual phenomenon of strong surface electron (charge) accumulation (1.57 × 1013 cm- 2) for the InN films grown on AlN film on a buffer layer . We proposing the miniaturized prototype, and packaging the ammonia gas sensor system (Including: Pt-InN sensor chip, heater, K-type thermocouple) on the 8 pin dual in-line package (DIP) for the portable human breath liver disease physiological detection application, shown in Fig 2. The current variation (DI) of a Pt-InN ammonia sensor under exposure to various ammonia concentrations from 0.2 ppm to 0.8 ppm in synthetic air at 200 °C is depicted in Fig 3. The experiments were repeatedly performed while the ammonia gas was turned on for 5 minute and off (i.e., in pure synthetic air) for another 5 minute at various ammonia concentrations. The current went up as ammonia concentration increased; such current increment was induced by the reduction of pre-adsorbed oxygen atoms. When ammonia molecules are introduced to the sensing system, the hydrogen atoms on dissociated ammonia molecules react with pre-adsorbed oxygen atoms, reducing the effects of surface depletion. Platinum as catalyst can increase output current signals as well as reduce response in comparison with Pt-InN, indicating that such an ammonia concentration can be analyzed in air. The dynamic responses of the Pt-InN sensor indeed demonstrate the great ability to sense ammonia gas at the sub-ppm level, and promising device for the realization of non-invasive ammonia sensing to detect ammonia in exhaled breath as a marker for liver disease. Figure 1

Ultrasensitive, real-time analysis of biomarkers in breath using tunable external cavity laser and off-axis cavity-enhanced absorption spectroscopy.

A robust biomedical sensor for ultrasensitive detection of biomarkers in breath based on a tunable external cavity laser (ECL) and an off-axis cavity-enhanced absorption spectroscopy (OA-CEAS) using an amplitude stabilizer is developed. A single-mode, narrow-linewidth, tunable ECL is demonstrated. A broadly coarse wavelength tuning range of 720 cm⁻¹ for the spectral range between 6890 and 6170 cm⁻¹ is achieved by rotating the diffraction grating forming a Littrow-type external-cavity configuration. A mode-hop-free tuning range of 1.85 cm⁻¹ is obtained. The linewidths below 140 kHz are recorded. The ECL is combined with an OA-CEAS to perform laser chemical sensing. Our system is able to detect any molecule in breath at concentrations to the ppbv range that have absorption lines in the spectral range between 1450 and 1620 nm. Ammonia is selected as target molecule to evaluate the performance of the sensor. Using the absorption line of ammonia at 6528.76 cm⁻¹, a minimum detectable absorption coefficient of approximately 1×10⁻⁸ cm⁻¹ is demonstrated for 256 averages. This is achieved for a 1.4-km absorption path length and a 2-s data-acquisition time. These results yield a detection sensitivity of approximately 8.6×10⁻¹⁰ cm⁻¹ Hz(-1/2). Ammonia in exhaled breath is analyzed and found in a concentration of 870 ppb for our example.

Fast and accurate exhaled breath ammonia measurement.

This exhaled breath ammonia method uses a fast and highly sensitive spectroscopic method known as quartz enhanced photoacoustic spectroscopy (QEPAS) that uses a quantum cascade based laser. The monitor is coupled to a sampler that measures mouth pressure and carbon dioxide. The system is temperature controlled and specifically designed to address the reactivity of this compound. The sampler provides immediate feedback to the subject and the technician on the quality of the breath effort. Together with the quick response time of the monitor, this system is capable of accurately measuring exhaled breath ammonia representative of deep lung systemic levels. Because the system is easy to use and produces real time results, it has enabled experiments to identify factors that influence measurements. For example, mouth rinse and oral pH reproducibly and significantly affect results and therefore must be controlled. Temperature and mode of breathing are other examples. As our understanding of these factors evolves, error is reduced, and clinical studies become more meaningful. This system is very reliable and individual measurements are inexpensive. The sampler is relatively inexpensive and quite portable, but the monitor is neither. This limits options for some clinical studies and provides rational for future innovations.

Fast and Accurate Exhaled Breath Ammonia Measurement

Fast and Accurate Exhaled Breath Ammonia Measurement

Mo1014 A High Protein Challenge Increases Gut-Derived Exhaled Breath Ammonia

Mo1014 A High Protein Challenge Increases Gut-Derived Exhaled Breath Ammonia

A calibration-free ammonia breath sensor using a quantum cascade laser with WMS 2f/1f

The amount of ammonia in exhaled breath has been linked to a variety of adverse medical conditions, including chronic kidney disease (CKD). The development of accurate, reliable breath sensors has the potential to improve medical care. Wavelength modulation spectroscopy with second harmonic normalized by the first harmonic (WMS 2f/1f) is a sensitive technique used in the development of calibration-free sensors. An ammonia gas sensor is designed and developed that uses a quantum cascade laser operating near 1,103.44 cm−1 and a multi-pass cell with an effective path length of 76.45 m. The sensor has a 7 ppbv detection limit and 5 % total uncertainty for breath measurements. The sensor was successfully used to detect ammonia in exhaled breath and compare healthy patients to patients diagnosed with CKD.