Department of Urology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama.
Department of Internal Medicine and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas.
J Urol. 2021 Sep;206(3):517-525. doi: 10.1097/JU.0000000000001846. Epub 2021 Apr 27.
We reviewed the available evidence regarding health disparities in kidney stone disease to identify knowledge gaps in this area.
A literature search was conducted using PubMed®, Embase® and Scopus® limited to articles published in English from 1971 to 2020. Articles were selected based on their relevance to disparities in kidney stone disease among adults in the United States.
Several large epidemiological studies suggest disproportionate increases in incidence and prevalence of kidney stone disease among women as well as Black and Hispanic individuals in the United States, whereas other studies of comparable size do not report racial and ethnic demographics. Numerous articles describe disparities in imaging utilization, metabolic workup completion, analgesia, surgical intervention, stone burden at presentation, surgical complications, followup, and quality of life based on race, ethnicity, socioeconomic status and place of residence. Differences in urinary parameters based on race, ethnicity and socioeconomic status may be explained by both dietary and physiological factors. All articles assessed had substantial risk of selection bias and confounding.
Health disparities are present in many aspects of kidney stone disease. Further research should focus not only on characterization of these disparities but also on interventions to reduce or eliminate them.
我们回顾了有关肾结石疾病健康差异的现有证据，以确定该领域的知识空白。
使用 PubMed®、Embase® 和 Scopus® 进行文献检索，仅限于 1971 年至 2020 年发表的英文文章。根据这些文章与美国成年人肾结石疾病差异的相关性来选择文章。
几项大型流行病学研究表明，美国女性以及黑人和西班牙裔人群肾结石疾病的发病率和患病率不成比例地增加，而其他规模相当的研究则没有报告种族和民族人口统计学数据。许多文章描述了基于种族、族裔、社会经济地位和居住地的影像学利用、代谢检查完成情况、镇痛、手术干预、就诊时结石负荷、手术并发症、随访和生活质量方面的差异。基于种族、族裔和社会经济地位的尿参数差异可能是由饮食和生理因素共同造成的。所有评估的文章都存在选择偏倚和混杂的高风险。
肾结石疾病的许多方面都存在健康差异。进一步的研究不仅应侧重于这些差异的特征描述，还应侧重于减少或消除这些差异的干预措施。
