From the Guidelines
Lemon water is not a reliable method to dissolve existing renal calculi, but it may help prevent kidney stones by increasing urinary citrate levels. The American College of Physicians recommends management with increased fluid intake spread throughout the day to achieve at least 2 L of urine per day to prevent recurrent nephrolithiasis 1. While lemon water may be beneficial in preventing kidney stones, its effectiveness in dissolving existing stones is unclear.
Key points to consider:
- Drinking lemon water regularly can increase urinary citrate levels, which may inhibit stone formation and potentially slow the growth of small stones.
- Established kidney stones typically require medical intervention such as extracorporeal shock wave lithotripsy, ureteroscopy, or in some cases, surgical removal.
- The preventive effect of lemon water works because citric acid in lemons binds with calcium in the urine, reducing the supersaturation that leads to stone formation.
In terms of prevention, increasing fluid intake to achieve at least 2 L of urine per day is a recommended strategy to prevent recurrent nephrolithiasis 1. If you already have kidney stones, especially larger ones, medical intervention is necessary, and lemon water alone is insufficient treatment. It is essential to consult a healthcare provider for proper diagnosis and treatment rather than relying solely on home remedies.
From the Research
Kidney Stone Dissolution and Lemon Water
- The relationship between lemon water and kidney stone dissolution is complex, with some studies suggesting that citrate, a component of lemon juice, can help prevent kidney stone formation 2, 3, 4.
- Citrate is a powerful inhibitor of the crystallization of calcium salts, which are a common component of kidney stones 2.
- Studies have shown that oral citrate therapy can increase urinary citrate levels, which can help bind to calcium and inhibit the crystallization of calcium salts, reducing stone formation 3, 5.
- However, the effect of potassium citrate on urine supersaturation and stone formation is complex and difficult to predict, and may not be beneficial in preventing calcium phosphate stone formation 5.
- A recent study found that lemon-derived extracellular vesicle-like nanoparticles can block the progression of kidney stones by antagonizing endoplasmic reticulum stress in renal tubular cells, suggesting a potential mechanism for the preventive effects of lemonade consumption on kidney stone formation 6.
Citrate and Kidney Stone Prevention
- Citrate salts, including potassium citrate, have been shown to be effective in preventing new stone formation and reducing further stone growth in patients with residual stones that predominantly contain oxalate 3.
- Dietary modifications, including high intake of fluids and fruits, especially citrus, sodium and protein restriction, and normal calcium intake, can also help prevent kidney stone formation 2.
- The use of supplements such as potassium citrate and magnesium citrate can help in the prevention of kidney stones of calcium oxalate, and may also be used to make stones more fragile before shockwave lithotripsy treatment 4.
Lemon Water and Kidney Stone Dissolution
- While there is limited direct evidence on the effectiveness of lemon water in dissolving renal calculi, the citrate content in lemon juice may help prevent kidney stone formation and reduce the risk of recurrence 2, 3, 6.
- Further research is needed to fully understand the relationship between lemon water and kidney stone dissolution, and to determine the optimal dosage and duration of treatment.