NNCC Certification Exams

Established in 1987, the Nephrology Nursing Certification Commission was created to develop and implement certification exams for nephrology nursing. The NNCC is an independent organization that collaborates with the Center for Nursing Education and Testing (C-NET) to develop, administer, and evaluate exams. The NNCC is recognized by the American Nephrology Nurse Association (ANNA) and works collaboratively with the ANNA to promote and advertise the exams that they offer.


The NNCC works to promote high standards for nephrology nursing practice through the administration of dialysis certification exams. These exams are designed to assess the competence of clinical care professionals who provide the services required to treat patients who suffer from end stage renal disease. Since patient care is a collaborative process that requires the combined efforts of physicians, nurses, and technicians, the NNCC has created exams that evaluate the skills of both nurses and technicians. In all, this organization offers six different exams to dialysis professionals including the certified dialysis nurse, certified dialysis LPN/LVN, certified nephrology nurse, certified clinical hemodialysis technician, advanced certified clinical dialysis technician, and certified nephrology nurse – nurse practitioner.

Technician Certification Exam Details

1) The Certified Clinical Hemodialysis Technician Exam (CCHT) – This exam contains 150 questions and allows testers to take up to 180 minutes to complete the entire exam. Questions are categorized into four broad content categories including clinical (~50%), technical (~23%), environment (~15%), and role (~12%). As you can see, the majority of the score is weighted toward clinical and technical knowledge and skills. While it is important to prepare for all areas of the exam, those that are weighted more heavily should receive greater attention during the exam preparation process. In addition, the questions in each of these categories are considered either knowledge-based or comprehension-based. A knowledge-based question requires an understanding of facts, terms, concepts and principles while a comprehension-based question requires the test-taker to interpret, compare, contrast, explain, estimate, or translate information.

Eligibility – In order to sit for the CCHT exam an applicant must have a high school diploma or equivalent, must complete a training program for clinical hemodialysis technicians that includes both classroom instruction and clinical experience, submit proof of completion of a training program, verify employment if a position has been held in the last eighteen months, proof of retraining and experience if a position has not been held in the previous eighteen months, and remain in compliance with federal and state regulations affecting the practice of a dialysis patient care technician.

Exam Fee – $225 if no special considerations are required

Exam Application – Click Here

Exam Preparation – The NNCC website provides excellent advice on preparing for the exam.


2) Certified Clinical Hemodialysis Technician Exam – Advanced (CCHT-A) – This exam is very similar to the CCHT exam. Test-takers are given 180 minutes to complete all 150 questions that are categorized in the same way as the CCHT. Those who plan to take the advanced version of the technician exam should be prepared for more of a challenge than is presented on the basic exam. The exam represents an advanced understanding of the profession and has more stringent eligibility requirements.

Eligibility – In order to take this exam, individuals must have a minimum of five years of continuous employment with a minimum of 5000 hours as a clinical hemodialysis technician, 30 hours of continuing education relevant to the field within the past 3 years, and current national certification as a dialysis technician. It is recommended that the continuing education be approved by an organization accredited by the American Nurses’ Credentialing Center – Commission on Accreditation (ANCC – COA), American Association of Critical-Care Nurses (AACN), the Council of Continuing Education, or the State Boards of Nursing in California, Florida, Iowa, Kansas, or Ohio.

Exam Fee – $250 if no special considerations are required

Exam Application – Click Here

Exam Preparation – The NNCC website provides excellent advice on preparing for the exam.

Nurse Certification Exam Details

The NNCC offers a variety of certification exams for individuals who wish to advance their career in the dialysis industry as a nurse. These exams are important because they may represent opportunities for technicians to take on more responsibility and earn a higher salary. Dialysis technicians should carefully consider the additional training and experience requirements associated with an exam before attempting to schedule a test date. It is also a good idea to ask employers about how nurse certification may help advance one’s career in the profession.

1) The Certified Dialysis LPN/LVN Exam (CD-LPN/LVN) – This exam also contains 150 questions with a maximum time limit of 180 minutes. Unlike the technician exams, the questions are divided into six categories that encompass clinical interventions (25%), role responsibilities (18%), technical and physiological principles (17%), pathology and complications (15%), medication administration (15%), and infection control (10%). Similar to the technician exams, questions can be classified as either knowledge-based (5%), comprehension-based (20%), or analysis and application (75%). As with all exams, it is important to focus your studies on aspects of the exam that have a large influence on the score. Focused study typically leads to optimal exam results.

Eligibility – As would be expected, the requirements for becoming eligible to take this exam are greater than those for the technician exams. Applicants must hold an unrestricted license as a licensed practice/licensed vocational nurse, have two years and 2000 hours of experience as an LPN/LVN working with dialysis patients, and complete 15 hours of continuing education relevant to dialysis patient care within the past two years. Accreditation by the organizations recognized by the ANCC-COA, AACN, Council of Continuing Education, or State Boards of Nursing in California, Florida, Iowa, Kansas, or Ohio is highly recommended.

Exam Fee – $250 if no special considerations are required

Exam Application – Click Here

Exam Preparation – The NNCC website provides excellent advice on preparing for the exam.

2) The Certified Dialysis Nurse Exam (CDN) – This exam is structured differently than the CD-LPN/LVN exam and contains 200 questions on the written version that must be completed in 4 hours or 150 questions on the computer-based version that must be completed in 3 hours. Questions are categorized into four different groups including renal failure (30%), hemodialysis (54%), peritoneal dialysis (12%), and transplant (4%). These four content areas contain questions that are meant to accomplish nine objectives including recognition of pathological processes and treatment modalities, selecting interventions, applying physiological and technical principles, selecting the appropriate teaching strategies, administering medications, appreciating the importance of an interdisciplinary approach to care, selecting that are appropriate given the psychological and sociocultural effects of kidney disease, applying the infection control principles, and understanding the importance of professional nursing practice in promoting outcomes.

Eligibility – The requirements to take this exam include a full and unrestricted license as a registered nurse, 2000 hours or more of experience as a registered nurse in nephrology nursing care within the past 2 years, and 15 hours of continuing education in nephrology nursing within the past 2 years. Foreign applicant eligibility is subject to a few unique requirements that can be reviewed on the NNCC website.

Exam Fee – $350 if no special considerations are required

Exam Application – Click Here

Exam Preparation – The NNCC website provides excellent advice on preparing for the exam.


3) Certified Nephrology Nurse Exam (CNN) – This exam is structured similar to the CDN exam except that there are 175 questions included on the computer-based version. Questions are grouped into 5 categories that include renal failure (35%), hemodialysis (30%), peritoneal dialysis (18%), transplant (12%), and acute therapies (5%). The overall objectives of this exam are the same as the CDN exam and should be reviewed in-depth before attempting to take this exam.

Eligibility – Applicants for this exam must have a full and unrestricted license as a registered nurse; complete at least 3000 hours of nephrology nursing experience in a clinical, administrative, teaching or research capacity within the past 3 years; possess a Baccalaureate in Nursing or a Master’s in Nursing Degree; and complete at least 30 hours of continuing education within the past 3 years.

Exam Fee – $350 if no special considerations are required

Exam Application – Click Here

Exam Preparation – The NNCC website provides excellent advice on preparing for the exam.

4) Individuals who would like to further advance their career in the industry may want to consider certification as a nurse practitioner in nephrology. The NNCC administers the Certified Nephrology Nurse – Nurse Practitioner (CNN-NP) exam for those who are interested in this advanced career option.

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