ALT A flow diagram illustrating the Canadian Society of Nephrology (CSN) process for developing commentaries. It begins with identifying relevant international guidelines, followed by forming a multidisciplinary working group including clinical experts, allied health professionals, and patient partners. Next, working group members review assigned chapters and complete a pre-meeting survey to assess which recommendations or practice points require discussion. Items flagged for evidence review or Canadian-specific implications are discussed at working group meetings. Based on these discussions, chapters are drafted using a standardized template. The draft is then reviewed by external peer reviewers. After revisions, the final commentary is submitted for publication and disseminated through various platforms including the CSN website, journals, and national networks.

ALT Figure 1. Differential diagnosis of hyperammonemia, organized by mechanisms of increased ammonia production and decreased ammonia clearance