Background: Patients suffering from (CKD) are in general at high risk for severe coronavirus disease (COVID-19), but dialysis-dependency (CKD5D) is poorly understood. We aimed to study clinical profile and outcome of CKD patients on hemodialysis with SARS-CoV-2 infection during pandemic in a tertiary care hospital. Methods: A total130 consecutive patients of CKD on hemodialysis with SARS-CoV-2 infection aged ≥13 years who attended or were admitted under the Department of General Medicine were included and were studied from Jan 2021 to May 2022. Results: The age group affected between 51-60 years (31.5%) with male predominance (57.7%). Generalized body swelling was commonest symptom (76.9%) and tachycardia was commonest sign (84.6%). Clinical profile of these patients showed the most common aetiology as diabetes nephropathy [61(46.9%)] followed by hypertensive nephrosclerosis [37(28.5%)]. The mean duration of dialysis was 4.75 months, ranged from 2 days to 5 years. Majority of the patients were presented in stage 5 CKD (52 patients). The mortality among CKD patients with COVID-19 was found to be 59.3%. Highest mortality (69.2%) was observed in stage 5 patients, in diabetic nephropathy (73.8%), high level of D-dimer (74.4%) and 100% mortality in HIV positive patients. Conclusion: CKD patients with severe COVID-19 illness who were treated with early elective intubation had found better outcome. Early hemodialysis and early elective intubation in patients with respiratory failure had good outcome. This study reveals, early use of anticoagulation in patients having tachycardia, tachypnoea and hypoxemia had better outcome. Early detection and effective management of these illnesses can delay the onset, progression of CKD and subsequent morbidity and the requirement of renal replacement therapy, if any.