Background: Primary hypothyroidism is common in CKD due to the well-established interaction between thyroid and kidney,impacting renal function.The objective of study was to evaluate the prevalence of subclinical (SCH) and overt hypothyroidism (OH) in patients with CKD and to compare the prevalence of hypothyroidism among patients with or without diabetic mellitus (DM). Methods: This observational prospective cohort study was conducted on patients aged ≥18 years of either sex with confirmed CKDfrom April 2015 to August 2016. Results: A total of 144 patients were included in the study, with a mean age of 48.92 years. Among them, 48.61% belonged to the age group of 41-60 years. Of the total study population, 47.22% had CKD with DM, and 52.78% had CKD without DM. The meaneGFR was comparable in patients of CKD with or without DM (16.34 ml/min/1.73m² vs 14.80 ml/min/1.73m²). Hypothyroidism was detected in 47.06% of CKD patients with DM, including 21.88% with OH and 78.13% with SCH. In CKD patients without DM, 48.68% had hypothyroidism, among those 32.43% had OH and 67.57% had SCH.The eGFR significantly increased for CKD patients on thyroid hormone replacement therapy (THRT) at both 3 and 6 months compared to baseline (p < 0.001). Conclusion: Hypothyroidism is substantially more common in CKD patients, and THRT has been shown to improve renal function, indicating its promise as a therapeutic intervention for CKD patients with hypothyroidism, regardless of DM status.