Chronic kidney disease is an irreversible condition that progresses relentlessly leading sooner or later to the end stage renal failure.The diagnosis of this stage can be achieved by eliciting the history carefully, discovering co-morbid factors, utilizing imaging techniques, interpreting histol. material and placing this in the context of probability derived from epidemiol. data.Screening of high-risk individuals- those with hypertension, diabetes mellitus, cardiovascular and other risk factors, lifestyle modification, phys. exercise, abstinence from smoking will retard the progression to ESRD.This will help in bringing down the huge burden due to the mismatch between demand and availability of resources for renal replacement therapy in developing countries like India, especially for patients belonging to lower socioeconomic group.The assessment of the clin. profile of these patients showed the most common etiol. as diabetes mellitus (36.9%).Hypertension being a cause and a complication of CKD was present in 64.6% of patients.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.Another manageable condition obstructive uropathy found in 10% of these patients, if treated at an early stage prevents progression to irreversible kidney damage.Cardiovascular disease in chronic kidney disease is more common in the presence of Diabetes mellitus, Hypertension, hypernatremia, increased kidney size, hypo albuminuria in patients with anemia, cardiovascular disease was more common when Hb levels were less than 5g/dL.Cardiovascular diseases as a morbidity were identified in 28.5% patients.Being the leading cause of mortality in CKD it would be imperative to monitor patients for this morbidity.Cardiac structural, as well as functional abnormalities, are common in patients with ESRD, more so in those with hypertension and anemia.LVH is the commonest cardiac abnormality in ESRD patients, followed by diastolic dysfunction.Both conditions are more marked in hypertensive patients and anemic patients.LVH has got prognostic implications, because this group of ESRD patients have a propensity of diastolic dysfunction or sudden cardiac death.