Lemon Juice Will Not Cure Existing Kidney Stones
Lemon juice has no role in dissolving or eliminating stones that have already formed—it only helps prevent new stone formation in patients with hypocitraturia. The evidence consistently shows that dietary interventions, including lemonade therapy, are preventive strategies, not treatments for existing stones 1.
Why Lemon Juice Cannot Cure Current Stones
Existing stones require mechanical removal or passage—no dietary intervention can dissolve formed calcium oxalate stones, which comprise the majority of kidney stones 1, 2.
The American College of Physicians guidelines focus exclusively on preventing recurrent nephrolithiasis, not treating active stones 1.
Once a stone has crystallized and formed, the biochemical environment that created it is no longer reversible through dietary citrate supplementation 2.
What Lemon Juice Actually Does (Prevention Only)
Lemonade therapy increases urinary citrate levels, which can help prevent future stone formation by binding calcium and inhibiting crystal formation 3, 4, 5.
Studies show urinary citrate increases by 200-400 mg/day with lemonade consumption, but this only affects the urinary environment going forward 3, 4, 5.
The stone formation rate decreased from 1.00 to 0.13 stones per patient per year in one study, but this represents prevention of new stones, not dissolution of existing ones 3.
Critical Distinction: Prevention vs. Treatment
All guideline recommendations address stone recurrence prevention, not acute stone management 1, 6.
The American College of Physicians explicitly states that increased fluid intake and dietary modifications are for preventing recurrent stones in patients with active disease 1.
For existing stones causing symptoms, treatment options include observation for spontaneous passage, ureteroscopy, or lithotripsy—not dietary manipulation 2.
What Actually Works for Current Stones
Increased fluid intake (achieving >2.5 liters urine output daily) may help facilitate passage of small stones but will not dissolve them 1, 6.
Antispasmodic medications and pain management are used for acute stone episodes 2.
Stones >5mm typically require urological intervention rather than conservative management 2.
Common Pitfall to Avoid
Do not delay appropriate urological evaluation by attempting dietary therapy for symptomatic stones—patients need imaging and assessment for intervention 2.
The lack of high-level evidence for lemonade as a curative treatment should temper expectations, as most studies show only preventive benefits 7.