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(3) renal â glutamine break down in proximal tubule (combines with H+ -> NH4+ and eliminated) CAUSES OF HYPERAMMONAEMIA. Overproduction of ammonia. Protein/ amino acid load. gastrointestinal hemorrhage. gastric bypass. multiple myeloma. allogeneic stem cell transplantation.
1 The urine tends to be concentrated and have a strong smell of ammonia when an individual fails to take in sufficient amounts of water.  Liver damage - This may also cause an ammonia smell in urine, because the liver is responsible for removing and breaking down ammonia.