Ammonia breath typically means that you’re not getting enough dialysis to remove the toxins in your blood. Ammonia in the breath indicates that your BUN is high. When you get dialysis, your BUN will drop. However, after dialysis, your BUN slowly starts to increase. I suspect that if you’re on 3 times a week dialysis, your breath smells worse as you get closer to the time to go to dialysis.
I worked in dialysis for years and never heard that vinegar helped this problem. However, if it does help, it’s only a temporary cover-up for the real problem, which is that you’re not getting dialysis often enough to keep your BUN below the point at which the ammonia smell begins.