The use of health claims data for epidemiology and costs of chronic kidney disease

The work presented in this thesis examines the possibilities of Dutch health claims data (stored in the Vektis database) for research in advanced chronic kidney disease (CKD) patients, being Stage G4-G5 CKD patients without kidney replacement therapy (KRT) and Stage G5 CKD patients with KRT (i.e. dialysis or kidney transplantation).
Health claims data is a relatively new source of data that offers new research opportunities for large populations of patients with kidney disease and health outcomes in a non-experimental setting. Despite the growing international popularity of health claims data, so far the use of health claims data for kidney research in the Netherlands was still in its infancy. This thesis aimed to examine the value of health claims data for kidney research by providing insight into the use of international health claims data used for nephrology research and their limitations (part 1) and by describing the validity of Dutch health claims data for the identification of CKD patients (part 2). Furthermore, this thesis aimed to study healthcare costs (part 3) and medication use (part 4) of CKD patients using Dutch health claims data.
We conclude that the Vektis database has the potential to be an important data source for observational nephrology research in the Netherlands. The characteristics of the Vektis database provide opportunities to study unique information (such as healthcare costs, healthcare utilization, and medication use) on a national level with the possibility to make comparisons with a matched subset from the general population. Nonetheless, valuable steps regarding data accessibility, knowledge exchange, and data linkage, could be taken to further improve the research potential of the Vektis database.