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The human body, like any other, is an intermediate component of the nitrogen cycle in nature. Consuming nitrogen from the external environment in the form of various compounds, the body processes it into ammonia - one of the final products of exchange of nitrogen-containing substances [1], which is removed from the body in the form of urea. The most active ammonia producers are organs with high exchange of amino acids and biogenic amines - nerve tissue, liver, intestine, and muscles. In a state of nitrogen equilibrium, the adult body consumes and releases about 15 g of nitrogen per day, temporary or permanent disruption of nitrogen balance results in a great number of physiological conditions and diseases, and the need to stabilize it is well known. However, despite a huge number of studies on the role of nitrogen metabolism and its compounds in the clinic, to date we have not been able to find any conciliation document in the world literature on the classification of ammonia-ammonium levels in human blood and approaches to the correction of hyperammonemia, which was the basis for the emergence of this consensus.

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Justification Given the large number of reports on the peculiarities of liver lesions during the Sars-Cov-2 infection [1], a team of experts who participated in the 23rd Congress of the Scientific Society of Gastroenterologists of Russia and 15 National Congress of Therapists of November 19, 2020 decided to make additions to the Russian Consensus of “Hyperammonemia in Adults” published early 2020 [2, 3].