The presence of nurse practitioners (NPs) in nephrology is not a new concept; literature out of the United States documents their existence quite well Since 1973, the collaboration of NPs and nephrologists has provided cost-effective care for dialysis patients and an alternative for health authorities anticipating a nephrologist shortage. Integration of NPs ensures high-quality, cost-effective, patient-focused care. In 1995, NPs began their integration into the Canadian nephrology field and, in 2004, the Northern Alberta Renal Program (NARP) hired its first nurse practitioner. Currently, there are five NPs who work collaboratively with nephrologists to manage and co-ordinate nephrology care. This article will review the history of NPs in Canada and the introduction of NPs in NARP.