When patients start experiencing end-stage kidney failure with about 90 percent of kidney function loss, dialysis is needed to remove waste, salt, and water that would otherwise build up within the body. Dialysis is an essential medical treatment for helping patients control their blood pressure and keep safe levels of chemicals circulating in their blood. Dialysis nurses specialize their registered nursing skills in providing this treatment and helping patients in renal failure maintain robust lives. Dialysis nurses may deliver hemodialysis in which a machine cleans the blood or peritoneal dialysis where a special fluid is injected into the abdomen. Dialysis nurses may also work with patients who’ve received a kidney transplant to ensure the new organ functions properly without signs of infection or rejection.


According to the U.S. Bureau of Labor Statistics, the 2.61 million registered nurses in America earn an average annual salary of $68,910, which could be equated to a mean hourly wage of $33.13. In particular, Payscale reports that dialysis registered nurses bring home an average yearly salary of $65,671 or $29.58 per hour with both health and dental insurance coverage.

Beginning Salary

When just starting out in the dialysis nursing specialty, registered nurses can expect to land in the bottom 10 percent of the profession with an annual salary around $47,333. However, it’s important to remember that dialysis nurses in senior-level supervisory positions with years of experience often make upwards of $82,755 each year.

Key Responsibilities

Dialysis nurses work under the direction of physicians with the responsibility of treating patients with various kidney diseases. Dialysis nurses will monitor the patient’s condition as blood is removed from their body, filtered through the dialysis machine, and replenished through another tube. Most dialysis nurses will need to educate patients and their family members about the treatment procedure as well as home management tips for renal diseases. On a typical day, dialysis nurses can be found keeping patients’ records, administering dialysis treatments, setting up treatment plans, observing patients, consulting with other healthcare workers, cleaning medical equipment, and watching for any adverse reactions. Some dialysis nurses will also supervise the work of LPNs and CNAs with dialysis patients.

Necessary Skills

In order to be successful, dialysis nurses must be emotionally stable and mature with the self-management skills needed to treat very sick patients who may never recover. Dialysis nurses should possess excellent interpersonal skills for clearly communicating with other healthcare professionals and teaching patients about at-home care. Being compassionate and sympathetic is essential for dialysis nurses to effectively motivate patients to stick through their dialysis treatments. Having good analytical skills with a detail-oriented mind is important for dialysis nurses to quickly notice any changes in their patients’ conditions. Dialysis nurses should also fine-tune their organizational skills to ensure thorough records are kept on each treatment.

Degree and Education Requirements

Before you can qualify for any dialysis nursing positions, you’ll first need to become a registered nurse (RN) by taking one of three currently accepted educational pathways. You can enroll in a hospital-based diploma program, earn an associate’s degree (ADN) in two years, or complete a four-year bachelor’s degree (BSN). Regardless of the option you choose, make sure that your nursing education has been fully accredited by the CCNE or ACEN. Most registered nursing degrees will include important coursework in human anatomy, physiology, biology, chemistry, nutrition, and other social sciences with clinical practicum. Aspiring dialysis nurses may also want to take specialized nephrology training to learn more about the urinary system.

Pros and Cons of the Position

One of the most obvious advantages of working in dialysis nursing is having the opportunity to make a decent living with good benefits while helping people truly in need. Dialysis nurses have the chance to make a difference in other’s lives by providing essential emotional support and keeping their kidneys as healthy as possible. Since there’s a very healthy job market filled with openings, dialysis nurses also have the flexibility to choose their work location and the stability to know ends will be met. On the flip side, some registered nurses find that dialysis nursing is too overwhelming with high levels of stress. Dialysis nurses work with potentially harmful chemicals daily and are sometimes exposed to infectious diseases from their patients. Although overtime is required less than some other RN specialties, dialysis nurses still typically need to work long shifts with evening and weekend hours too.

Getting Started

While earning an appropriate education, it’s advised that you start building your resume with nephrology experience by working with dialysis patients during your practica. After graduation, you’ll be well-equipped with the nursing knowledge and practical skills needed to take the National Council Licensure Examination (NCLEX-RN) in your state of residence. With your RN license in hand, you can start applying for staff nursing positions and supplement your degree with real-life work experience. Many aspiring dialysis nurses decide to complete a residency program that will focus specifically on the ins and outs of dialysis nursing. Once you’ve obtained at least 2,000 hours of experience in nephrology, you should also consider pursuing the Certified Dialysis Nurse (CDN) credential through the Nephrology Nursing Certification Commission (NNCC). You’ll need to recertify every three years after passing the certification exam with continuing education credits.

Future Outlook

As with other nursing specialty areas, there’s expected to be a fast-growing need for dialysis nurses to fulfill critical nursing shortages and meet the growing demand for healthcare services. Dialysis nurses may even experience above-average job growth because the massive baby boomer population is reaching the later stages of life and battling various chronic conditions that can cause renal failure, including high blood pressure and diabetes. According to the Bureau of Labor Statistics, employment growth for dialysis nurses and other RNs will skyrocket much faster than normal at the rate of 19 percent, thus creating 526,800 new jobs before 2022. Dialysis nurses will likely find favorable job prospects in hospitals, community clinics, nursing homes, home health services, dialysis centers, and outpatient care facilities.

Whether they’re called renal nurses or nephrology nurses, dialysis nurses specialize their medical skills in providing the life-saving treatment of dialysis to regularly remove toxins from the body. Dialysis nurses spend each day providing both physical and mental support to patients who are battling acute or chronic kidney failure. If you make the decision to become a dialysis nurse, you’ll join the caring healthcare team to ensure dialysis patients have the highest level of well-being possible.