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Renal ammonia handling is driven primarily by acidbase disturbances and liver failure, with the kidneys promoting ammonia excretion to limit systemic accumulation in advanced liver disease or after portosystemic shunting [51]

Diabetes Care (2015) 38(1):15965.10.2337/dc14-0769 176 YatsunenkoTReyFEManaryMJTrehanIDominguez-BelloMGContrerasMet alHuman gut microbiome viewed across age and geography