Kidney stones during pregnancy are formed mainly due to the sedentary lifestyle of women during this period, as well as a sharp change in the entire water-salt balance of the body.
This is also complemented by a violation of calcium and phosphorus metabolism: most of these elements enter the placenta and are necessary for the unborn child for the normal development of the skeleton.
Why are stones formed?
Diagnosis of the disease
Diagnosis of urolithiasis in pregnant women includes:
- (indicates the current salt balance, as well as the presence of antibodies or blood, which may indicate an active inflammatory process);
- , bladder, ureters (allows you to establish the presence of stones, as well as their location);
- spiral computed tomography (allows you to visually assess the condition of the kidneys, as well as to identify hidden internal bleeding).
Radiography is not performed, but, at the direction of the doctor, it can be replaced with an endoscopy. Such a procedure will allow you to check the condition of the ureters, but before it is necessarily carried out blockade of the ligament of the uterus(so as not to provoke a spasm).
What to do, how to treat?
If urolithiasis is detected in the acute stage, pregnant women are required to be hospitalized and followed by a medical supervision.
After the diagnosis, the woman is examined, the current clinical picture is established and treatment is prescribed. In most cases - a "sparing" method, involving the use of diuretics, potassium bicarbonate solution, Soluran, and so on.
All this is necessary to normalize the water-salt balance, as well as maintaining the pH level within 6.2–6.9. In most cases this is enough for the gradual dissolution and removal of stones from the urinary system.
In the event that the attacks do not stop or a blockage of the ureters is detected, then an operation is prescribed.
In any case, doctors will postpone this procedure until the last moment and, if possible, combine it with a caesarean section. In the early stages of pregnancy, the operation is not performed, since the likelihood of complications or miscarriage is very high.
Also, the patient may be prescribed antibiotics if, in addition to urolithiasis, an infection was detected (pyelonephritis or inflammation of the bladder).
And from folk methods of treatment(dissolving stones) the most effective are:
- milk decoction of flax seeds (30 grams of crushed seeds are mixed with 3 cups of hot milk, leave for 3 hours, drink 1 cup on an empty stomach daily);
- a decoction of knotweed (3 teaspoons of dry grass, pour 2 cups of boiling water, leave to cool, take 0.5 cups daily);
- radish juice (3 times a day, 2 tablespoons).
Before using folk methods, you should definitely consult with a gynecologist (whose woman is registered) or a urologist.
So, during pregnancy, the likelihood of kidney stones really grows. The most dangerous thing about this is kidney spasms.
If these occur, then hospitalization is indispensable. Doctors advise even at the stage of pregnancy planning to undergo an ultrasound examination of the kidneys and, if necessary, completely get rid of the disease in the initial stage.
Why do kidneys hurt in pregnant women, find out from the video:
Pregnancy is one of the most exciting and happiest periods in a woman's life. But sometimes the expectation of a baby is overshadowed by various health problems of the expectant mother. In recent years, women in an interesting position are increasingly diagnosed with diseases of the genitourinary system. One of the most common problems are stones in the Consequences and treatment of this disease will be described in today's article.
Features of the functioning of the kidneys during pregnancy
During all nine months from the moment of conception, a double burden falls on the body of the expectant mother. And this applies to all organs, including the kidneys. During pregnancy, the latter have to process and remove from the body the waste products of not only the woman herself, but also the fetus. During this period, there is a significant increase in the volume of urine excreted. In the last months of pregnancy, this figure increases to 1200-1600 milliliters.
In addition, progesterone present in the blood helps to reduce the tone of the bladder, as a result of which urine stagnation may occur. The combination of these factors often leads to the fact that the expectant mother has kidney stones. During pregnancy, a fast-growing fetus puts pressure on a woman's internal organs. As a result, the risk of developing various pathologies increases significantly. To avoid serious health problems, you need to regularly visit a doctor from the fourth month of pregnancy and strictly follow his instructions.
Causes of the problem
There are several factors that cause a kidney stone to appear during pregnancy. Most often, this pathology is associated with the changed hormonal background of a woman. In the body of the expectant mother, the concentration of progesterone increases sharply. This hormone not only prevents miscarriage, but also contributes to the appearance of kidney stones. It inhibits the activity of the smooth muscles of the urinary tract, which leads to stagnation of urine.
An equally common reason why a kidney stone appears during pregnancy is a physiological decrease in immunity. It is this factor that most often provokes the development of inflammatory processes. Infection in the urinary tract, combined with stagnant urine, contributes to the formation of stones.
An equally important role is played by a decrease in motor activity, leading to a violation of phosphorus-calcium metabolism, and the diet of a pregnant woman. A future mother needs to carefully monitor her diet. During pregnancy, it is desirable to reduce the consumption of meat products, since they contribute to the formation of uric acid salts.
Characteristic symptoms
Kidney stones during pregnancy (the treatment of this pathology will be discussed a little later) can be recognized by several main signs. As a rule, this ailment is accompanied by mild aching pains localized in the lower back. Sometimes they give to the stomach, thigh or perineum. If the stone has scratched the wall of the ureter or renal pelvis, then blood may appear in the urine.
Other signs that make it possible to recognize this pathology include flatulence, nausea, fever and chills. Also, the vast majority of patients often experience vomiting and painful urination.
Diagnostic methods
If there is the slightest suspicion of a kidney stone during pregnancy, you should immediately consult a doctor. He will recommend to undergo a number of laboratory tests and additional studies. All this will help in making an accurate diagnosis.
As a rule, in such cases, a general analysis of urine is prescribed (according to Nechiporenko or Zimnitsky), which allows to determine the concentration of salts, as well as blood biochemistry for urea and creatinine. In addition, the patient will be referred for an ultrasound of the kidneys. This is one of the safest research methods that allows you to identify pathology.
Pregnancy and kidney stones: what is the threat?
By themselves, they are not dangerous to the health of the unborn baby, since they have absolutely no effect on the formation of the organs and tissues of the embryo. A real threat arises only in the presence of a large stone that clogs the duct and causes stagnation of urine. Therefore, it is very important not to delay the treatment of this pathology. In cases where the disease is aggravated by an infectious lesion, there is a risk of infection of the placenta of the fetus.
In addition, a kidney stone during pregnancy is often accompanied by inflammation and pain. Severe colic accompanied by severe fever can cause premature birth or miscarriage. In addition, a stone moving along the ureter often provokes detachment of the fetal egg from the uterine wall.
What to do during an attack of colic?
As a rule, a sharp pain appears due to the fact that a kidney stone during pregnancy (we have already found out how dangerous this condition is for the health of the unborn baby) blocks the ureter and prevents the excretion of urine. Therefore, in such cases, it is necessary to try to take a position in which it will move and open the channel.
To relieve spasm, you can take an anesthetic drug recommended by your doctor. It is strictly forbidden to independently use any medications not prescribed by a doctor. During an attack of renal colic, it is forbidden to take warm relaxing baths and carry out any warming procedures.
How to treat kidney stones during pregnancy?
What to do in such situations, only the doctor should decide. As a rule, a decision is made on drug therapy. Operations during pregnancy are done only in exceptional cases. Surgical intervention is indicated only when the stones caused the development of a fast-flowing purulent process or provoked acute renal failure.
Treatment of kidney stones should be comprehensive. Therefore, taking drugs is almost always supplemented with a special diet. A special diet allows you to facilitate the work of the kidneys and makes the therapy more complete.
With urate stones, patients are advised to exclude meat from the diet. In this case, the diet is based on dairy and plant products. If a lot of calcium is found in the stones, then it is advisable to include cereals and meat in the menu. In this case, you need to completely abandon eggs, milk and legumes. They should also be excluded if oxalic acid is found in stones.
Prevention measures
Kidney stones, like any other pathology, are better prevented than treated later. Prevention comes down to correcting the diet, an active lifestyle, and taking herbal medicines prescribed by a doctor.
To avoid the formation of stones from the menu of a pregnant woman, it is necessary to completely remove carbonated drinks, smoked meats and fried foods. It is also undesirable to eat chicken eggs, potatoes, peanuts, chocolate and a large number of confectionery. Foods such as bananas, apples and watermelons have a beneficial effect on kidney function. For the prevention of urolithiasis, you can use buckwheat and millet porridge.
As for drinks, to prevent the development of pathology, it is recommended to use fresh juices, as well as herbal and berry decoctions. Cowberries, blueberries and parsley are best suited for these purposes.
In addition, it is necessary to regularly visit a doctor and systematically take the required tests. All this will allow you to track the slightest malfunctions in the body and not miss the initial stage of the disease.
Even a normal pregnancy is a real stress for the female body. On this basis, all chronic diseases at once remind the expectant mother of themselves. Kidney stones during pregnancy are a clear confirmation of this. Pathology poses a serious danger to the woman and the baby she is carrying. But a prudent examination of the organs of the urinary system even at the stage of planning offspring helps to avoid problems in the future. We will talk about the symptoms and treatment of the disease in the article.
Factors that provoke the formation of stones in the organs of the urinary system are divided into internal and external. The main catalyst for the development of urolithiasis is considered to be a disturbed water-salt metabolism in the body. However, there are other reasons for the formation of kidney stones in the mother during fetal development:
- susceptibility to disease due to a genetic factor;
- specific nutrition (the disease can cause a large number of meat dishes in the diet);
- hormonal disorders;
- bacteriuria, occurring without visible signs;
- vitamin deficiency;
- diseases of the gastrointestinal tract;
- gout;
- disorders in the development of the nervous system;
- chronic diseases of the urinary system;
- disturbances in the activity of the urinary system;
- body dehydration.
The risk of kidney stones is especially high in the last trimester of pregnancy, when a large belly prevents the expectant mother from leading an active lifestyle. Also during this period, disorders in metabolic processes often occur due to unstable hormonal levels. How dangerous is the presence of kidney stones during pregnancy? A real threat to the well-being of the mother and baby is the rapid exacerbation of the pathology, while the sluggish form of the disease does not harm their health.
Why urolithiasis worsens during pregnancy
During pregnancy, a woman's hormonal activity increases markedly, and this leads to an inevitable exacerbation of urolithiasis. That is why expecting a baby and bouts of renal colic are often parallel processes. The body of the expectant mother synthesizes the hormone progesterone in large quantities, since a high level of this substance is the key to a successful pregnancy. Numerous progesterone receptors are present in the tissues of the organs of the urinary system, therefore, when it becomes larger, the urinary ducts expand and lose their tone, facilitating the movement of stones. At this very time, the uterus constantly increases in size, compresses the ureters and interferes with the free excretion of urinary fluid.
Signs and specifics of the course of urolithiasis during pregnancy
Symptoms of the disease appear in expectant mothers in the period from 12 to 16 weeks of an “interesting” position, sometimes a few weeks before the baby is born. A pregnant woman is tormented by a sharp paroxysmal pain. The exacerbation occurs on the basis of a strong load experienced by the urinary tract of a pregnant woman. In some cases, urolithiasis in a future mother is diagnosed against the background of the development of pyelonephritis.
The clinical picture of urolithiasis is very extensive:
- the appearance of sharp pains in the lumbar region;
- an increase in discomfort when walking, changing the posture of the body, during and after exercise;
- increase in body temperature;
- the appearance of trembling in the body;
- bouts of nausea and vomiting;
- problems with urination (if the stones are large);
- the appearance of pain in the groin, perineum and lower abdomen;
- the appearance of bloody impurities in the urine.
The main and most eloquent sign of urolithiasis is an attack of renal colic, which literally covers a person with sudden and very sharp pain. This is how the body reacts to the movement of stones when they block the urinary ducts and prevent the normal excretion of urine. During an attack, there are short-term periods of relief, which are replaced by relapses. The attack passes when the stone changes position in the body or leaves the duct.
Consequences of kidney stones during pregnancy
Chronic urolithiasis occurs without obvious signs and does not pose a serious danger to a woman in position. However, the appearance of attacks of renal colic or the development of an extensive inflammatory process may result in premature birth or spontaneous abortion.
During an attack, the smooth muscle cells of the urinary tract contract. On this basis, the uterus is in a state of hypertonicity. Strong stress leads to placental abruption, miscarriage or premature labor. The presence of calculi in the kidneys and bladder is a real hindrance to natural delivery, so doctors often decide about operative delivery through caesarean section.
Kidney stones are also dangerous because they are a provoking factor for the development of another inflammatory disease - pyelonephritis. In this case, the infection threatens not only the woman, but also calls into question the health of the fetus. Treatment of pregnant patients takes place under the strict supervision of physicians.
Treatment of kidney stones during pregnancy
To alleviate the condition of a future mother suffering from urolithiasis, all means are good, so the course of treatment is usually complex.
Conservative treatment of kidney stones during pregnancy
Such therapy is complicated by the fact that many effective drugs are contraindicated for pregnant women. Treatment of urolithiasis in expectant mothers is aimed at suppressing pain symptoms, splitting and removing stones from the body, as well as removing the inflammatory process.
To alleviate the condition of a pregnant patient, the doctor prescribes her antispasmodics and anti-inflammatory drugs, the action of which does not threaten her position. Along with treatment that improves the general well-being of the expectant mother, the doctor will certainly pay attention to her drinking regimen. It is corrected properly: the daily volume of drinking water consumed is determined individually for each patient.
Such a measure is necessary to stimulate the production of urine and change the acidic environment to an alkaline one. In a severe form of urolithiasis, when drugs that have a sparing effect do not help relieve pain, they resort to painkillers of narcotic origin. If the painful sensations are not eliminated, a novocaine blockade of the round ligament of the uterus is made and at the same time urine is drained through a catheter.
Homeopathic treatment of kidney stones during pregnancy
Homeopaths know how to remove kidney stones during pregnancy. Homeopathic medicines are of particular relevance when it comes to the treatment of a pregnant patient. Such medicines are distinguished by a composition that is natural and safe for the woman and the fetus and successfully cope with the correction of disturbed metabolic processes. To enhance the effect, in parallel with taking homeopathic medicines, the expectant mother is prescribed herbal treatment. Considering that many herbs cannot be taken during pregnancy, only a doctor can develop a treatment program.
Diet in the treatment of urolithiasis during pregnancy
To keep the disease in check, dietary nutrition should not be underestimated. This issue is of particular importance when it comes to the treatment of the expectant mother. Before prescribing this or that diet, the attending physician will examine the pregnant patient to find out the composition of the stones that have formed in her kidneys.
Basically, the nutritional requirements of a woman in position are as follows:
- with stones of urate nature, the emphasis is on plant foods, sharply limiting the amount of meat and offal;
- stones in the form of calcium salts require the presence in the diet of meat products, various cereals and fruits. A partial taboo is imposed on eggs, dairy and legumes, potatoes;
- if the examination showed that the stones are based on oxalic acid salts, tomatoes, eggs, dairy and legumes should be abandoned.
With any form of urolithiasis and any composition of stones, spicy, salty and fried foods are contraindicated. In this case, it is best to give preference to fish and meat of low-fat varieties, steamed, and food of plant origin, namely:
- watermelons, pears, melons and gooseberries (natural diuretics);
- white cabbage (normalizes diuresis);
- cranberry fruit drinks (an effective diuretic and bactericidal agent).
Surgical treatment of kidney stones during pregnancy
If conservative therapy was ineffective, and the expectant mother did not feel better, doctors are forced to take extreme measures. It cannot be denied that surgical intervention can have a negative impact on the course of pregnancy and provoke its spontaneous termination, however, in especially severe cases, the expected harm from the operation is much less than the risk of losing the baby.
Surgical intervention is carried out with the use of anesthesia. During the operation, the cavities of the organs of the urinary system are cleared of stones. This method of treatment allows a woman not only to save the child, but also to give birth to him on time. If the symptoms of urolithiasis made themselves felt at a gestational age of 36 weeks, labor is stimulated, and the stones are removed after the baby is born.
Kidney stones during pregnancy: what to do during an attack of renal colic
A painful attack of urolithiasis in a pregnant woman begins, as a rule, suddenly and rapidly. First of all, you need to call an ambulance. Prior to her arrival, first aid consists in the use of an antispasmodic drug, which will partially eliminate the painful sensations. However, it should be remembered that not all antispasmodics are suitable for a pregnant woman. According to doctors, it is safest to take No-shpu (Drotaverine), Papaverine and Nitroglycerin. A Nitroglycerin tablet is placed under the tongue - a fast-acting drug stimulates the relaxation of smooth muscle muscles. Until the doctor arrives, it is imperative to monitor the volume of urine excreted, which is collected in a dry, clean container for further examination.
Kidney stones during pregnancy: what not to do during an attack of renal colic
- In no case should you heat the places of greatest localization of pain (back, lower back) with a hot heating pad.
- You can't take a hot bath.
- Do not take medicines that contain narcotic substances.
Prevention of the development of attacks of renal colic during pregnancy
According to the reviews of women who encountered kidney stones during pregnancy, they were able to avoid the manifestation of painful attacks by observing certain preventive measures:
- a balanced diet (a doctor will help to make it, taking into account the specifics of the disease);
- rejection of all spicy, fried and salty foods;
- drinking regimen (you need to acquire a useful habit of drinking at least 2 liters of purified drinking water per day);
- healthy lifestyle: regular exercise (after coordinating the program of physical activity with the doctor), daily walks and a good night's sleep.
These rules are relevant not only for expectant mothers who often have symptoms of urolithiasis, but also for women in a position with a history of various anomalies of the urinary system.
Regularly cooperating with the doctor, the expectant mother will ensure the normal development and course of pregnancy, as well as the safe birth of the baby. Self-medication in this situation is unacceptable, since urolithiasis can lead to serious consequences for the health of a woman and her child. If any incomprehensible symptoms and painful sensations appear, you should immediately report this to the specialist in charge of the pregnancy.
The primary formation of renal calculi during pregnancy does not occur, because there are no violations of mineral metabolism, and conditions are created in the urinary tract that prevent salts from precipitating. But if a woman had urolithiasis (ICD) before conception, then complications may arise during the bearing of the baby. Optimally in advance, but if this did not happen, then kidney stones during pregnancy will not interfere with calmly carrying and giving birth to a baby, subject to constant monitoring and following all the doctor's recommendations.
Changes in the body of a pregnant woman create positive and negative conditions that affect kidney stones. The risk of new stones forming is extremely low, but already existing stones can have a negative impact on a woman's urinary tract during pregnancy.
The positive impact of pregnancy on urolithiasis:
- most of the calcium, magnesium and phosphorus goes to the fetus, so even while taking complex vitamin and mineral preparations in the blood and urine of a woman, there will never be high concentrations of minerals;
- biochemical changes in the urine of a pregnant woman prevent the precipitation of mineral salts in the urinary sediment.
The negative impact of pregnancy in nephrolithiasis:
- the hormonal background during pregnancy contributes to an increase in the lumen of the ureters, expansion of the pelvis, which can provoke the discharge of large stones with a severe pain attack;
- during pregnancy, an exacerbation of chronic nephritis often occurs or the first episode of gestational pyelonephritis occurs, which worsens the course of the disease;
- due to anatomical changes in the abdomen, congestion in the kidneys is much more likely (the uterus with the fetus presses on the kidneys and ureters);
- gestation significantly limits the doctor in the methods of diagnosis and treatment options for urolithiasis.
Specificity of symptoms
Kidney stones during pregnancy are much more likely to move to the exit, provoking an attack of renal colic. In fact, severe pain in the side becomes the first and most striking manifestation of kidney stones. In addition, typical symptoms are manifested by the following signs:
- pain from the lower back extends to the thigh and to the inguinal region along the ureter;
- nausea, vomiting, stool disorders with bloating occur;
- a pregnant woman urinates frequently, experiencing pain when emptying the bladder;
- it is possible to increase the temperature with chills during exacerbation of pyelonephritis;
- Outwardly, the urine looks cloudy and reddish, which is due to inflammation and hematuria.
Frequent pain attacks and exacerbation of a kidney infection become the most unpleasant and dangerous factors during childbearing.
Diagnosis of the disease
During pregnancy, you can not do any X-ray studies. If a woman is aware of the presence of kidney stones, then the doctor will use old x-rays taken before pregnancy.
You can assess the condition of the kidneys and identify the stone using an ultrasound scan. However, the method has significant limitations in the diagnosis of nephrolithiasis, not always helping to make the correct diagnosis.
According to the indications, it will be necessary to perform a chromocystoscopy, but using the endoscopic technique, stones can only be detected in the bladder or ureter.
It is imperative to pass general clinical tests that will help in identifying acute or chronic pyelonephritis.
Treatment options
During pregnancy, it is better to use non-surgical methods of treatment. Principles of therapy:
- remove or prevent an attack of severe pain during the passage of the stone;
- ensure a good outflow of urine from the kidneys;
- remove inflammation.
At the time of acute pain, antispasmodics and painkillers should be used. A course of antibacterial and anti-inflammatory therapy is required. In a calm period, you can be treated with herbal uroseptics. An important condition for drug treatment is that only those drugs that are not prohibited during gestation should be used.
It is categorically contraindicated for the treatment of urolithiasis in pregnant women, the method of remote lithotripsy. Surgical intervention is used only under strict indications:
- if it is impossible to save a woman from severe pain against the background of an attack of renal colic;
- with blockage of the ureters with a complete absence of urine (obstructive anuria).
Possible Complications
Pyelonephritis and nephrolithiasis can have a negative effect on pregnancy, especially if there are complicated variants of inflammation in the kidneys or attacks of renal colic often recur. A woman in a position with a diagnosis of ICD needs to be wary of the following unpleasant complications:
- untimely termination of pregnancy (spontaneous abortion, late miscarriage, early birth);
- increased blood pressure with a risk of eclampsia;
- preeclampsia with edema and the appearance of protein in the urine;
- infection from the kidneys into the blood (sepsis);
- intrauterine infection of the fetus.
Uncomplicated nephrolithiasis will not interfere with the bearing of the fetus if the woman is regularly observed and follows the recommendations of the general practitioner and obstetrician-gynecologist. The need for treatment in the hospital arises only with acute pyelonephritis, severe lumbar pain and impaired urination. The only contraindication for maintaining pregnancy is severe renal failure, which threatens the woman's life.
Kidney stones and pregnancy are conditions that rarely occur together, because. after conception in the female body, the likelihood of salt precipitation decreases. At the same time, stones formed before pregnancy can cause complications, both at the stage of the 9-month period and labor activity.
Symptoms of kidney stones during pregnancy
Basically, kidney stones in pregnant women appear even before conception, and during gestation, urolithiasis intensifies, if before that the signs did not make themselves felt. This situation is explained by hormonal changes, all tissue structures are subject to softening, which leads to the movement of stones through the urinary system.Kidney stones during pregnancy are accompanied by vivid symptoms:
- pain syndrome spreads to the hips, spine and to the inguinal zone as the stones move along the ureter;
- feeling of nausea and vomiting together with a violation of the stool;
- pain or burning when urinating;
- an increase in temperature and chills when an infectious process is attached;
- hematuria and turbidity of urine is caused by an inflammatory reaction.
Impact of pregnancy on kidney stones
Kidney stones and pregnancy are characterized by both positive and negative influence factors. First of all, the development of the embryo inside the womb and the changes associated with it reduce the risk of calculus formation. This situation is due to the fact that a woman needs all the microelements in double volume for the normal formation of the fetus, the salts simply do not have time to be deposited. Also, a change in the biochemical composition of urine prevents the accumulation of mineral salts.Among the negative points, it can be noted that, against the background of hormonal changes, an already existing disease threatens the normal state of a woman. The lumens of the ureters and renal pelvis increase, the situation threatens the passage of stones and the subsequent occurrence of renal colic.
The consequences of the discharge of stones during pregnancy can be dangerous for intrauterine formation and for a woman. The pressure of the uterus on the genitourinary system leads to congestion, urine accumulates, there is a risk of infection and the development of pyelonephritis. At the same time, directly urolithiasis without signs of colic does not affect the course of pregnancy.
What to do if kidney stones during pregnancy?
After diagnosing urolithiasis in a pregnant woman and in the absence of pain, doctors most often decide on the dynamic monitoring of the course of the disease. And only with severe renal pain, it is supposed to use painkillers with the use of drugs to reduce the tone of the uterus.It is possible to treat urolithiasis with an attached infection only with antibacterial agents. In this case, all existing risks are taken into account, because this kind of therapy is dangerous for intrauterine development.
Acute unbearable pain during the passage of stones in the later stages involves the use of surgical intervention using a caesarean section. In the first or second trimesters, a minimally invasive intervention to remove stones is possible, but only if the stones lead to discomfort and discomfort.
In the absence of pain and no changes, treatment of kidney stones during pregnancy is possible with appropriate preventive measures. A special diet is prescribed, the essence of which may vary depending on the type of stones:
- with urate stones, meat dishes should be minimized, while the consumption of dairy and vegetable foods should be increased;
- with calcium salts, it is necessary to reduce the consumption of milk and eggs, at the same time increase the proportion of meat, cereals and fruits in the daily menu;
- in the presence of oxalic acid salts, it is recommended to limit the same foods. As with calcium salts.
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