ABSTRACT Aim Assess whether drinking freshly squeezed lemons in water (lemon water) influences serum urate (SU) levels, glomerular filtration rate (GFR), and urine pH levels in gout patients and individuals with hyperuricemia. Methods In this cohort study, we retrospectively analyzed the medical records of patients who presented to two outpatient Polish rheumatology clinics. Patients who consumed the juice of two squeezed lemons mixed with 2 L of water each day, according to a general recommendation made by clinic providers, were included in this analysis. We collected all relevant medical and medication histories from each patient. SU levels, GFR, and urine pH were extracted from the medical record. Results The study included 90 patients who reported consumption of lemon juice. The mean age was 49.2 years, and 69% were men. The patients were categorized into three groups: Group A consisted of gout patients, Group B included individuals with hyperuricemia but without gout, and Group C served as a control group with diagnoses other than gout. After six weeks, SU levels decreased from baseline in Group A compared to Group B ( p = 0.03) and in Group B compared to Group C ( p = 0.003), and there was an increase in GFR when comparing Group A to Group B ( p = 0.03) and Group A to Group C ( p = 0.0007). Conclusions After 6 weeks of drinking lemon water, a statistically significant reduction in SU level and improved GFR was observed. Lemon water may serve as a beneficial adjunct therapy for individuals with gout and hyperuricemia.