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Mechanisms of ammoniagenesis. Multiple pathways for enzymatic ammonia production originating from glutamine metabolism are present in the proximal tubule. Glutamine metabolism through phosphate-dependent glutaminase (PDG) and glutamate dehydrogenase (GDH) and involving phosphoenolpyruvate carboxykinase (PEPCK) is the quantitatively most significant component of renal ammoniagenesis and the primary pathway stimulated in response to metabolic acidosis.
