Disparities in Kidney Stone Disease: A Scoping Review

PURPOSE: To review the available evidence regarding health disparities in kidney stone disease and identify knowledge gaps in this area. MATERIALS AND METHODS: 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. RESULTS: Several large epidemiologic 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, follow-up, 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 physiologic factors. All articles assessed had substantial risk of selection bias and confounding. CONCLUSIONS: 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.