The breath ammonia measurement of the hemodialysis with a QCM-NH3 sensor

Recently, expired gases are analyzed non-invasively for monitoring the substances in the blood. Breath ammonia has been shown to correlate with BUN (blood urea nitrogen) and Cr (creatinine), both of which are indicators of solute removal in hemodialysis. In this study, breath ammonia concentration was continuously measured using a crystal oscillator QCM (quartz crystal microbalance) during the expiration of patients undergoing dialysis treatment. The results show that NH3 (ammonia) decreased gradually as the treatment proceeded. A strong correlation was observed between changes in the frequency of the QCM gas sensor and both the pre-dialysis BUN level (r=0.71, p<0.05) and the post-dialysis BUN level (r=0.90, p<0.05). NH3 was found to fall precipitously during dialysis. The differences were statistically significant. In addition, we found a statistically significant correlation between BUN and NH3 in expired gas. These results suggest that continuous measurement of NH3 is useful to assess the status of solute removal during hemodialysis.