The chemical composition of lemon water makes it an interesting consideration for the treatment or prevention of kidney stones because it can raise the citrate level of urine. Citrate is a form of citric acid which is abundant in lemons and other citrus fruits. The March 2011 issue of "Nature Reviews: Urology" reports that citrate is a well-known inhibitor of kidney stone formation and a high level in urine is beneficial. However, according to the article, it's difficult to consistently maintain a helpful level of urine citrate by drinking lemon water.
Lemonade vs. Drugs
Researchers reporting in the September 1996 issue of "The Journal of Urology" sought to determine if drinking lemonade is a viable alternative to pharmacological treatment of kidney stones. The researchers enrolled 12 patients who had failed conventional drug therapies for raising urine citrate levels because they were either noncompliant or intolerant. They drank lemonade consisting of 4 oz. of reconstituted lemon juice mixed with tap water. After six days, the citrate level in their urine was compared to baseline and 11 of the patients had more than doubled their citrate levels without increasing the volume of urine.
Lemonade for the Long-Term
Researchers reporting in the April 2007 issue of "The Journal of Urology" investigated whether or not long-term consumption of lemonade would beneficially raise citrate levels in the urine. The researchers enrolled 32 patients and put them on either lemonade therapy or a drug that slowly releases citrate in the body. They followed the patients for an average of 43 months and throughout performed tests and evaluations. The patients taking the drug performed only slightly better on all measures than did the lemonade drinkers. The researchers concluded that lemonade is a reasonable alternative for long-term treatment and prevention.
Lemonade vs. Other Citrus Beverages
The June 2008 issue of the "Journal of Endourology" investigated the citrate levels in a variety of citrus-based beverages. Of interest, they also measured the citrate levels in diet drinks. In terms of fruit juices, the highest levels were found in grapefruit juice, with lemon juice coming in second. These were followed by orange juice, pineapple juice and reconstituted lemonade. The diet beverage Crystal Light lemonade tested higher than did cranberry juice, followed by lemon flavored Gatorade, homemade lemonade, Mountain Dew and Diet 7Up. The researchers conclude these beverages may be an effective alternative to medical management.
How Much Lemonade to Drink?
The Stone Center, a website dedicated to information about kidney and related stones, advises people prone to forming stones to drink enough fluid to put out at least two quarts of urine every day. They explain that the urine flow washes crystals from the system before they have an opportunity to adhere and form a stone. They emphasize the importance of drinking fluids high in citrate and recommend lemonade made from frozen concentrate, real lemon juice or real lemons.
References
- "Nature Reviews: Urology"; Long-Term Lemonade-Based Dietary Manipulation in Patients With Hypocitraturic Nephrolithiasis; Michael Kurtz, et al.; March 2011
- "The Journal of Urology"; Dietary Manipulation With Lemonade to Treat Hypocitraturic Calcium Nephrolithiasissis; Matthew Seltzer et al.; September 1996
- "The Journal of Urology"; Dietary Manipulation With Lemonade to Treat Hypocitraturic Calcium Nephrolithiasissis; David Kang et al.; April 2007
- "Journal of Endourology"; Assessment of Citrate Concentrations in Citrus Fruit-Based Juices and Beverages; Georgia Haleblian et al.; June 2008
- The Stone Center: Stone Prevention
