What is a Nephrology Nurse Practitioner? (Duties, Steps to Become, & Salary)


Written By: Kasee WiesenKasee Wiesen DNP, APRN, FNP-C

Kasee Wiesen is a practicing family nurse practitioner. Her nursing background includes emergency medicine, pediatrics and peri-op. She started her health career as a nurse’s aid while pursuing her bachelor’s in nursing degree in a hospital setting. Education is a passion of Kasee’s, and after working as a BSN prepared nursed, she obtained in master’s in nursing education and began teaching adjunct for a local university. Read Full Bio »»
DNP, APRN, FNP-C


Are you interested and driven to learn more about the renal system? Do you want to help people improve their kidney function or care for those receiving dialysis? Do you want to form close relationships with patients and families as an expert in nephrology? If you answered yes to any of the above questions, have you thought about pursuing a career as a nephrology NP?

So, what is a nephrology nurse practitioner? A nephrology nurse practitioner often works alongside a team of physicians and other professionals to treat various renal problems of their patients. Please continue reading below to learn more about nephrology nurse practitioners, including what they do, the steps to becoming one, and salary information.


What Does a Nephrology Nurse Practitioner Do? – 6 Main Duties and Responsibilities


1. Complete thorough assessments of patients with emphasis on the renal system:

As a nephrology NP, you will perform a thorough history and physicals on your patients, emphasizing the renal system. This includes gathering subjective and objective data and completing thorough notes stating any findings, abnormal or normal, which will allow you to trend changes with the patient while they are in your care.

2. Order and interpret diagnostic tests, including imaging and labs:

You will order diagnostic tests, including images such as renal ultrasounds and labs, including kidney function, hemoglobin A1C, urinalysis, and other labs, to evaluate and monitor the function of the kidneys as a nephrology NP. Besides ordering these tests, you will also interpret them, creating treatment plans based on the results.


3. Medication management:

As a nephrology NP, medication management is essential to your job. You will prescribe medications for hypertension, electrolyte imbalances, autoimmune diseases such as lupus, and diabetes. You will also prescribe medications to preserve renal function. You may also manage medication status post-renal transplant.

Not only will you prescribe medications, but you will also review the patient's medication list at each visit to ensure they are not prescribed medications that will further damage or decrease the function of their kidneys (nephrotoxic drugs). If you identify any nephrotoxic medicines, you will work with their other healthcare providers to change prescriptions when possible. As a primary care provider, I cannot begin to count the number of times I have contacted the nephrologist of one of my patients to ensure the patient’s medications are okay with their kidney function and to discuss the starting of a new medication prior to initiation. I have found this relationship invaluable as it helps ensure the patient receives the best treatment possible.

4. Decrease their patient's risk of further kidney damage:

Nephrology nurse practitioners primarily aim to decrease their patients' risk of further kidney damage, preserve their patients' kidney function, and, in some instances, improve the function of their patients' kidneys. They achieve this through thorough examinations, knowing the appropriate tests that need to be completed, and having a solid understanding of medications, treatments, etc., that may cause further damage to the person's kidneys.

5. Collaborate with other health professionals caring for your patient:

As a nephrology NP your focus is on the renal system/kidneys, therefore, you will collaborate with many other health professionals, including primary care, endocrinology, cardiology, and hematology/oncology, to ensure your patient receives comprehensive, holistic care. As an NP in family practice, I frequently collaborate with nephrology to ensure the appropriate treatment of our mutual patients.

6. Care for patients who have received a kidney transplant or are awaiting a kidney transplant:

Another role of the nephrology NP is to care for patients who have received or are awaiting a kidney transplant. Not all nephrology NPs do this, but if you work inpatient, care for patients receiving dialysis, or in specific outpatient clinics, you may find patients awaiting or receiving a kidney transplant.


Where Do Nephrology Nurse Practitioners Mostly Work? – Top 3 Work Settings


Nephrology nurse practitioners can work in various settings—and I will explain three of the top work settings for nephrology NPs below.

1. Outpatient/Clinic:

Many nephrology NPs work in the outpatient or clinic setting. While working here, you will see patients for their follow-ups, order and review diagnostic tests, and manage medications for patients with chronic kidney disease.

2. Inpatient:

As a nephrology NP, you may also work in the inpatient setting. In this role, you will work alongside a physician and care for patients with chronic kidney disease while inpatient in a hospital. This will include ordering diagnostic tests, interpreting labs, managing medications, and ordering dialysis when indicated.

3. Dialysis Clinic:

Another top nephrology NP setting is a dialysis clinic. While this is technically an outpatient setting, it is a highly specific treatment for those with chronic kidney disease. As the nephrology NP working here, you will focus on ensuring that patients receive their treatment appropriately, manage their care during dialysis, ensure they tolerate it well, and schedule their follow-up appointments.


What is the Typical Work Schedule and Work Hours of a Nephrology NP?


As a nephrology NP, you typically work from 8 am to 5 pm Monday through Friday. If you care for patients in the inpatient setting, you may work longer days, weekends, and holidays. Rarely do you work overnight as a nephrology NP. But you may have to be on-call in the evening, overnight, on weekends, and holidays, which would involve answering patients’ questions or providing orders to nursing staff.


What Education is Required to Become a Nephrology Nurse Practitioner After High School?


To become a nephrology nurse practitioner, after high school, you must attend and graduate from an accredited BSN program. You can achieve this by completing a traditional BSN program or an RN to BSN program. Once you have your BSN, you can apply to a graduate nurse practitioner program. I recommend specializing in family practice or adult gerontology, as these will best prepare you for your career as a nephrology NP. Your graduate program can be either an MSN or a DNP program.


How Long Does It Take to Become a Nephrology NP After High School?


Program TypeProgram Length
BSN36 to 48 Months
BSN-to-MSN (NP)12 to 24 Months
BSN-to-DNP (NP)36 to 48 Months


How Much Does It Cost to Become a Nephrology NP After High School?


Program TypeProgram Cost
BSN$8,730 - $219,450
BSN-to-MSN (NP)$20,740 - $201,980
BSN-to-DNP (NP)$28,390 - $277,320


What is the Step-By-Step Process of Becoming a Nephrology Nurse Practitioner After High School?


Below you will find a step-by-step process to become a nephrology NP after high school.

STEP #1: Graduate from an accredited BSN program



STEP #2: Pass NCLEX and obtain RN licensure:

After you graduate from an accredited BSN program, you must pass the NCLEX exam and obtain RN licensure in your state of residence.

STEP #3: Gain experience caring for patients receiving nephrology care:

This step is not required, but I strongly recommend you gain experience caring for patients receiving nephrology care before becoming a nephrology nurse practitioner. This can be in the inpatient setting, as a dialysis nurse, or as a nurse in a nephrology clinic. The experience you gain as a nephrology RN will be invaluable to your NP. You are making connections and building relationships with others in the specialty, which will only help you in your career.

STEP #4: Apply to graduate school:

Once you have a minimum of one to two years of experience as an RN, apply to a nurse practitioner graduate program. When applying, you will declare the specialty you want to pursue. Family practice or adult gerontology will best prepare you for a career as a nephrology NP. If pediatrics is the population you want to work with, I’d also consider the pediatrics acute care specialty.

Your graduate program may be an MSN or DNP program.

STEP #5: Complete and graduate from an accredited NP program



STEP #6: Pass your board certification exam and obtain NP licensure:

Once you graduate from your NP program, you must pass the board certification exam specific to the NP specialty associated with your degree. Once you are board-certified, you can obtain NP licensure in your state of residence.

STEP #7: Apply for nephrology NP jobs:

This step could have occurred earlier, as many students apply for nephrology NP jobs before graduation, but if you still need to apply for nephrology NP jobs, now is the time to do it!

STEP #8: Enjoy your career as a nephrology NP!



STEP #9: Complete the CNN-NP Certification:

It is strongly encouraged that you complete the CNN-NP certification—but before you can complete you must have a minimum of BOTH 2,000 hours AND two years as a nurse practitioner practicing in nephrology within two years before submitting the application. You must also complete twenty approved continuing education hours in nephrology within two years before submitting an application for this certification.


What are the Required or Recommended Certifications for Nephrology Nurse Practitioners?


Certified Nephrology Nurse-Nurse Practitioner (CNN-NP):

The CNN-NP certification is specific to nephrology nurse practitioners. It demonstrates a commitment to providing high-quality, evidence-based care to those with kidney disease.


Are There Any Fellowship or Residency Programs Available for Nephrology Nurse Practitioners?


Mayo Clinic College of Medicine and Science Nurse Practitioner Nephrology and Hypertension Fellowship (Florida):

The nephrology NP fellowship program through the Mayo Clinic College of Medicine and Science in Florida offers a 12-month program focusing on care for patients needing nephrology care and management of hypertension. This program includes didactic and clinical experiences in the inpatient, outpatient, and outpatient dialysis settings.


What is the Starting Salary of a New Grad Nephrology Nurse Practitioner?


The starting salary of a new grad nephrology nurse practitioner is $91,870, which breaks down to $44.17 an hour.

Hourly$44.17
Weekly$1,767
Monthly$7,660
Annual$91,870


What is the Average Salary of a Nephrology Nurse Practitioner?


The average nephrology nurse practitioner salary is $131,150 a year or $63.05 an hour. This number varies based on where you live, work, and years of experience as a nephrology NP.

Hourly$63.05
Weekly$2,522
Monthly$10,930
Annual$131,150
(Source: Nursingprocess.org)


What is the Salary by Level of Experience of a Nephrology NP?


As mentioned above, your years of experience as a nephrology NP will impact your annual salary. An entry-level nephrology NP has an average yearly salary of $91,870, whereas a nephrology NP with 5-9 years of experience has an average annual salary of $127,920. If you have a passion for nephrology and have worked in the specialty for over 20 years, you can earn an average annual salary of $173,810.

Level of ExperienceHourlyWeeklyMonthlyAnnual
Entry-Level$44.17$1,767$7,660$91,870
1-4 Years of Experience$52.22$2,089$9,050$108,610
5-9 Years of Experience$61.50$2,460$10,660$127,920
10-19 Years of Experience$68.51$2,740$11,880$142,500
20 Years or More Experience$83.56$3,343$14,480$173,810


What is the Average Salary of a Nephrology NP by State?


StateHourlyWeeklyMonthlyAnnual
Alabama$53.91$2,157$9,350$112,140
Alaska$58.86$2,354$10,200$122,430
Arizona$61.40$2,456$10,640$127,710
Arkansas$54.17$2,167$9,390$112,670
California$79.97$3,199$13,860$166,340
Colorado$58.88$2,355$10,210$122,480
Connecticut$66.50$2,660$11,530$138,310
Delaware$60.98$2,439$10,570$126,830
Florida$55.78$2,231$9,670$116,030
Georgia$58.38$2,335$10,120$121,430
Hawaii$64.89$2,596$11,250$134,970
Idaho$59.53$2,381$10,320$123,830
Illinois$61.86$2,474$10,720$128,660
Indiana$61.56$2,463$10,670$128,050
Iowa$64.82$2,593$11,240$134,830
Kansas$56.47$2,259$9,790$117,460
Kentucky$55.27$2,211$9,580$114,960
Louisiana$59.78$2,391$10,360$124,340
Maine$59.83$2,393$10,370$124,440
Maryland$60.51$2,420$10,490$125,860
Massachusetts$70.14$2,806$12,160$145,900
Michigan$57.54$2,302$9,970$119,680
Minnesota$64.81$2,593$11,230$134,810
Mississippi$59.30$2,372$10,280$123,340
Missouri$57.24$2,289$9,920$119,050
Montana$60.67$2,427$10,520$126,190
Nebraska$60.16$2,407$10,430$125,140
Nevada$68.89$2,756$11,940$143,300
New Hampshire$63.61$2,544$11,030$132,310
New Jersey$72.44$2,898$12,560$150,680
New Mexico$65.52$2,621$11,360$136,280
New York$71.54$2,862$12,400$148,810
North Carolina$57.88$2,315$10,030$120,390
North Dakota$57.62$2,305$9,990$119,850
Ohio$59.39$2,376$10,290$123,530
Oklahoma$61.57$2,463$10,670$128,060
Oregon$68.90$2,756$11,940$143,320
Pennsylvania$60.97$2,439$10,570$126,810
Rhode Island$63.34$2,534$10,980$131,750
South Carolina$55.19$2,208$9,570$114,790
South Dakota$58.47$2,339$10,130$121,610
Tennessee$50.23$2,009$8,710$104,480
Texas$63.04$2,522$10,930$131,130
Utah$58.47$2,339$10,130$121,610
Vermont$58.97$2,359$10,220$122,660
Virginia$59.16$2,366$10,250$123,050
Washington$68.57$2,743$11,890$142,630
West Virginia$54.00$2,160$9,360$112,330
Wisconsin$61.30$2,452$10,630$127,500
Wyoming$58.27$2,331$10,100$121,210


What is the Job Outlook Like for This Career?


The job outlook for the nephrology NP is very promising—between 2022 and 2032, there is a predicted job growth of more than 44%. This growth rate is exceptionally higher than many jobs due to the aging population and advancements in medicine that allow us to manage patients' chronic diseases, including chronic kidney/renal disease, better and more efficiently.

2022-32
+44.54%


Useful Organizations and Associations


1. American Nephrology Nurses Association (ANNA)

2. Association of Nephrology Nurses (ANN)

3. American Society of Nephrology (ASN)



My Final Thoughts


Based on my experience in my clinic, we will continue to see nephrology utilized more and more in the inpatient and outpatient setting over the next several years. With this increase in demand, there is a need for more healthcare providers specializing in nephrology, supporting the need for more nephrology NPs to help meet the healthcare needs of our patients.

After reading the above, I hope you can now answer the question, what is a nephrology nurse practitioner? I have explained the role of a nephrology nurse practitioner, including what they do, the steps to become one, and salary information.


Frequently Asked Questions Answered


1. On Average, How Much Does A Nephrology NP Make Per Hour?

The average salary of a Nephrology nurse practitioner per hour is $63.05.

$63.05



2. On Average, How Much Does A Nephrology NP Make Per Week?

The average salary of a Nephrology nurse practitioner per week is $2,522.

$2,522


3. On Average, How Much Does A Nephrology NP Make Per Month?

The average salary of a Nephrology nurse practitioner per month is $10,930.

$10,930


4. On Average, How Much Does A Nephrology NP Make Per Year?

The average salary of a Nephrology nurse practitioner per year is $131,150.

$131,150


List of Sources Used for This Article


1. https://my.clevelandclinic.org/health/articles/24214-nephrologist
2. https://www.nncc-exam.org/certification/cnn-np
3. https://college.mayo.edu/academics/health-sciences-education/nurse-practitioner-or-physician-assistant-nephrology-and-hypertension-fellowship-florida/curriculum/


Kasee Wiesen DNP, APRN, FNP-C
Kasee Wiesen is a practicing family nurse practitioner. Her nursing background includes emergency medicine, pediatrics and peri-op. Education is a passion of Kasee’s, and she has taught BSN, RN-BSN and DNP students, and has enjoyed every moment of it!