Society of Diabetic Nephropathy Prevention Journal of Nephropharmacology 2345-4202 15 1 2026 01 01 Economic trend in kidney transplantation costs in the world; insights from the ISN global kidney health atlas 2019-2023 e12817 e12817 10.34172/npj.2025.12817 EN Sina Salem Ahim https://orcid.org/0009-0008-2452-434X Rasoul Jafari Arismani https://orcid.org/0000-0001-7440-0507 Maryam Miri https://orcid.org/0000-0002-9962-6753 Sara Ghaseminejad Kermani https://orcid.org/0000-0002-1730-8437 Motahareh Sabaghi Qala Nou https://orcid.org/0009-0005-7932-0799 Zahra Eydizadeh https://orcid.org/0009-0005-5411-6417 Ali Emadzadeh https://orcid.org/0009-0000-7311-1164 Kamran Safa https://orcid.org/0000-0002-3630-5418 Maede Safari https://orcid.org/0000-0002-8610-8316 Journal Article 10.34172/npj.2025.12817 2025 08 24 2025 10 22 Introduction: Kidney transplantation is a critical treatment for end-stage kidney disease, but its costs vary widely across countries and over time. Objectives: This study investigates changes in kidney transplantation costs between 2019 and 2023 using data from the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA). Methods: This ecological study analyzed kidney transplantation costs reported globally for 2019 and 2023 using data from the ISN-GKHA. The study included countries with complete cost data for both years, excluding those with missing or inconsistent records. Data collection focused on extracting first-year and subsequent annual transplantation costs from the publicly available ISN database. The primary outcome was the change in transplantation costs over time, evaluated to identify trends and regional variations in expenses across the included countries. Results: The trend from 2019 to 2023 in kidney transplantation costs varies by continent and globally. In Latin America, Brazil showed the highest increase, while Bolivia had the smallest. Oceania and Southeast Asia saw Australia with the largest increase and Indonesia with a decrease. Western Europe had the Netherlands with the greatest rise and Germany with a decrease. Saudi Arabia had the highest increase in the Middle East, while the West Bank and Gaza had the least. South Asia’s Bangladesh showed a modest increase. In North America, the United States experienced the largest increase, whereas Canada had a decrease. North and East Asia saw Japan with the most notable increase and China with a decrease. Africa had Morocco with the highest increase and Egypt with the smallest. Eastern and Central Europe recorded the largest rise in Slovenia and the smallest in Serbia. Overall, the United States had the most significant increase, while Germany showed the greatest decrease. Conclusion: The findings highlight significant regional disparities in kidney transplantation costs globally, emphasizing the necessity for targeted healthcare policies and ongoing monitoring to ensure cost-effective and equitable access to transplantation services worldwide.