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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 If the liver is unable to break down the ammonia it is excreted in the urine.  Other diseases - Other common causes of the ammonia smell in urine are diabetes, metabolic disorders, sexually transmitted diseases, medications, vitamins, and nutritional supplements.