Browsing by Author "Hsieh, Ju-Chun"

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A low-cost, portable and easy-operated salivary urea sensor for point-of-care application
(2019-05-01)
Wang, Kuan-Hsun
;
Hsieh, Ju-Chun
;
Chen, Chang-Chiang
;
Zan, Hsiao-Wen
;
Meng, Hsin-Fei
Salivary urea was reported to be a useful biomarker to reflect the blood urea nitrogen in chronic kidney disease patients. However, as a new biomarker, enormous clinical trials are required to define the intended-use and to verify the specification. In this report, we demonstrated a low-cost easy-operated real-time sensing system (optical fiber-urea-sensing, OFUS, system) to detect salivary urea. We aim to make the system easily reproduced by the community to stimulate abundant clinical tests worldwide. The OFUS system is composed of a simple three-dimensional printed tank to link with two optical fibers, one connecting with a commercial light-emitting diode to deliver the input light signal, the other connecting with a commercial cadmium sulfide photo-conductive cell to detect the sensing signal. To allow on-site detection without any sample pretreatment, only 1 mu l saliva is needed to be mixed with 10 mu l urease solution and 90 mu l pH indicator solution in the reaction tank and the detection time is only 20 s. A stable and reproducible calibration curve can be easily built with a detection range as 24-300 mg/dL. The OFUS system successfully detected saliva with added synthetic urea and samples from chronic kidney disease patients. A good agreement between the OFUS system and the commercial kit was obtained. A good correlation between salivary urea and the blood urea nitrogen was also confirmed.
Correlation between breath ammonia and blood urea nitrogen levels in chronic kidney disease and dialysis patients
(2020-07-01)
Chen, Chang-Chiang
;
Hsieh, Ju-Chun
;
Chao, Cheng-Han
;
Yang, Wei-Shun
;
Cheng, Hui-Teng
Previous studies have shown that breath ammonia (breath-NH3) concentration is associated with blood urea nitrogen (BUN) levels. However, interindividual variations in breath-NH3 concentrations were observed. Thus, the present study aimed to assess the effect of oral cavity conditions on breath-NH3 concentration and to validate whether the measurement of breath-NH3 concentration is feasible in clinical settings. A total of 125 individuals, including patients with stage 3 to 5 chronic kidney disease (CKD3-5), those on dialysis, and healthy participants, were recruited. A nanostructured sensor was used to detect breath-NH3 concentrations. Pre- and post-gargling as well as pre- and post-hemodialysis (HD) breath-NH3, salivary pH, and salivary urea levels were measured. Breath-NH3, salivary urea, salivary pH, and BUN levels were positively correlated to each other. Breath-NH3 concentrations were associated with BUN levels (r = 0.43, p < 0.001) and were significantly higher in CKD3-5 (p < 0.005) and dialysis patients (p < 0.001) than in healthy participants. Higher correlation coefficients were noted between breath-NH3 concentrations and BUN levels during follow-up (r = 0.59-0.94, p < 0.05). When the cutoff value of breath-NH3 was set at 523.65 ppb, its sensitivity and specificity in predicting CKD (BUN level >24 mg dl(-1)) were 87.6% and 80.9%, respectively. Breath-NH3 concentrations decreased after HD (p < 0.001) and immediately after gargling (p < 0.01). Breath-NH3 concentration, which was affected by gargling, was correlated to BUN level. The measurement of breath-NH3 concentration using the nanostructured device may be used as a tool for CKD detection and personalized point-of-care for CKD and dialysis patients. The current study had a small sample size. Thus, further studies with a larger cohort must be conducted to validate the effect of oral factors on breath-NH3 concentration and to validate the benefit of breath-NH3 measurement.