There has been a rapid increase in the incidence of chronic kidney disease and those requiring renal replacement therapy. Managing these patients requires a multidisciplinary team approach. Clinical nurse specialists (CNS's) play a vital role in ensuring the highest quality care is delivered in a cost-effective manner. There is an acute shortage of CNS' in the Middle East and other developing countries. Development of the CNS's role necessitates comprehensive training programs in conjunction with multi-stakeholder acceptance. This article hereby addresses the various steps in developing such a role as facilitating nurses to work to their full professional and academic potential ensures best practice.