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Ethical approval was obtained from the IATRC Review Board. All procedures involving human urine samples complied with the principles of the Declaration of Helsinki. Written informed consent was obtained from all participants, and all samples were anonymized to protect confidentiality.
Sensor design and numerical simulation
The first step in designing a sensor is to run an electromagnetic simulation. CST Microwave Studio is used to make the layout, which includes a resonator made up of a circular spiral inductor (CSI) in series with an interdigital capacitor (IDC). There is a connection point for a LDR between these parts that lets them work together optically25. To improve performance, two Hilbert fractal open stubs are added to the CSI-IDC junction to reduce electromagnetic field fringing and distortion. A back-loop structure is also added to the ground plane to make the band-reject filter response more stable and improve measurement accuracy26. The design works best on a standard, low-cost FR4 substrate (εr≈ 4.3, thickness 1.6 mm) and has a main operational resonance at 1.22 GHz. We used software to create and analyze an equivalent lumped-element circuit model to check the simulated S-parameters. This made sure that the results from full-wave electromagnetic and circuit simulations were the same27. The selection of LDR as the optical transducing element was driven by its distinct advantages in this specific microwave sensing architecture. Unlike photodiodes or phototransistors, which require complex biasing circuits and offer a nonlinear current-to-light relationship, the LDR provides a passive, linear, and wide-range resistive modulation in response to incident light intensity. This linear shift in resistance directly modulates S21 of the adjacent microwave resonator without introducing active circuit noise or requiring additional signal conditioning. Furthermore, the LDR's low cost, compact footprint, and seamless integration with the FR4 substrate—requiring no external biasing lines—align with the overall design goal of a simple, low-cost, and non-invasive point-of-care sensor.
To contextualize the proposed sensor within the broader landscape of urea detection technologies, a brief comparison with established methods is warranted. Biochemical assays, such as the enzymatic urease method, represent the clinical gold standard, offering high accuracy and sensitivity (detection limits as low as 1–5 mg/dL) but requiring specialized laboratory equipment, trained personnel, and typical turnaround times of 30–60 min, limiting their utility in point-of-care settings. Enzymatic test strips provide a rapid (2–5 min), low-cost, semi-quantitative alternative suitable for at-home use; however, they rely on colorimetric interpretation, which can be subjective, and offer limited sensitivity for precise concentration measurement. Electrochemical sensors, including amperometric and potentiometric urea biosensors, achieve high sensitivity and enable real-time detection, yet they often require complex electrode fabrication and enzyme immobilization, and suffer from stability issues due to enzyme degradation over time. In contrast, the proposed optically controlled microwave sensor offers a unique combination of attributes: non-invasive optical coupling eliminates direct sample contact with sensing elements, reducing contamination risk; measurement time is under 30 seconds; fabrication on low-cost FR4 substrate minimizes expense; and the linear relationship between urea concentration and insertion loss (S21) simplifies calibration. While the current sensitivity (1.42 × 10-4 per mg/mol/cm3) is suitable for categorical classification of clinically relevant urea ranges (150–450 mg/dL), further optimization may enhance detection limits comparable to electrochemical counterparts. Overall, the sensor occupies a complementary niche, prioritizing simplicity, speed, and portability for point-of-care applications where laboratory-grade precision is not essential.
Sensor fabrication
Standard photolithography moves the finished design to a single-sided copper-clad FR4 board. A high-resolution photomask is used to make the sensor pattern on a substrate that has been laminated with photoresist. The pattern is then developed and etched in a solution of ferric chloride (FeCl₃). After etching and cleaning, SubMiniature version A (SMA) connectors are carefully soldered to the input and output microstrip ports so that measurement equipment can be connected28. This process makes a working, low-profile sensor that is ready for testing.
Experimental setup and calibration
Using high-quality coaxial cables, the made-up sensor is connected to a vector network analyzer (VNA), like an Agilent PNA series. Using a mechanical calibration kit, a full two-port calibration (Open, Short, Load, Through) is done at the ends of the cable to get rid of systematic measurement errors. To measure the sensor's S-parameters, the VNA is set up to sweep from 0.1 GHz to 4 GHz with an output power of -10 dBm29.
Urine sample preparation and measurement procedure
Participants who agree to give their urine samples are asked to do so. A fixed test platform is set up for measurement: an LDR is placed directly below a clean glass slide that is centered over the active region of the sensor. First, a baseline S21 measurement is taken with the LDR lit up by a light source with a constant intensity and no sample present. Then, a 0.01 mL droplet of urine is pipetted onto the middle of the glass slide. The S21 spectrum is recorded again with the same amount of light. The sample's optical properties that depend on urea change the LDR's resistance, which causes a measurable change in the sensor's |S21| at 1.22 GHz30. To avoid cross-contamination, the glass slide is cleaned with distilled water and ethanol between each sample measurement. Fresh urine samples were collected from ten healthy volunteers (five male, five female; age 25–45 years). Baseline urea concentrations, measured via a clinical chemistry analyzer, ranged from 150 to 450 mg/dL. To establish a controlled testing range, samples were categorized into three concentration groups: low (150–250 mg/dL), intermediate (251–350 mg/dL), and high (351–450 mg/dL), with ten samples per category. All samples were analyzed within 2 h of collection, stored at 4 °C when not in use, and equilibrated to room temperature prior to measurement. A 0.01 mL aliquot was applied to a clean glass slide for each test, with slides cleaned using 70% ethanol and distilled water between measurements to prevent cross-contamination30.
Data acquisition and analysis
The main piece of information taken from each measurement is the size of S21 (in dB) at the 1.22 GHz resonance. This dataset is used to teach a K-Nearest Neighbors (KNN) algorithm that runs in a program like MATLAB. The model uses the S21 magnitude to put urea levels into groups like "low," "intermediate," and "high"31. Also, the sensor's concentration sensitivity can be measured by plotting the change in |S21| (Δ|S21|) against the change in urea concentration (ΔC). The slope of this linear relationship, C = ΔS / ΔC, shows the sensitivity. To evaluate sensor robustness and measurement reliability, a repeatability study was conducted with 45 measurements per urea concentration category (low: 150–250 mg/dL, intermediate: 251–350 mg/dL, high: 351–450 mg/dL) across three independent days, totaling 135 measurements. The coefficient of variation ranged from 0.67% to 1.07% across all categories, indicating excellent measurement repeatability. Measurement uncertainty was quantified following the Guide to the Expression of Uncertainty in Measurement (GUM) framework, combining Type A uncertainty (statistical variation from repeated measurements) with Type B contributions from VNA calibration (±0.05 dB), temperature fluctuations (±0.01 dB/°C), and sample positioning variations (±0.02 dB). The expanded uncertainty (k=2, 95% confidence interval) ranged from ±0.38 dB to ±0.56 dB, depending on concentration category. The concentration sensitivity, derived from linear regression of Δ|S21| versus ΔC, was calculated as 1.42 × 10-4 per (mg/mol/cm3), with a 95% confidence interval of 1.35 × 10-4 to 1.49 × 10-4 per (mg/mol/cm3) and a coefficient of determination (R2) of 0.94. The relative expanded uncertainty in sensitivity was ±6.2% (k = 2), confirming that the reported sensitivity is statistically robust and the sensor demonstrates reproducible performance suitable for point-of-care applications.