Background: Drug utilization studies in CKD patients help to understand and build evidence for the drug use. CKD patients have coexistence of both concordant and discordant comorbidities attributed to persisting polypharmacy, which makes it very important to study the prescribing trend on a regular basis. Objectives:The purpose of this study is to conduct a systematic review of prescription patterns, evaluate treatment compliance with standard guidelines as outlined by KDIGO, and determine evidence-based practices. We plan to develop symptom-specific questionnaires with scoring systems to track the progression and severity of the disease. Our analysis will help determine the prevalence, risk factors, comorbidities, and overall drug usage associated with chronic kidney disease as prevalence of chronic kidney disease is high, and due to lack of prescribing guidelines specific to this disease, there is significant risk of adverse reaction. Materials and Methods: An observational prospective drug utilization study was carried out in- patients of BAPS Pramukh Swami Hospital, Surat for a duration of 6 months. CKD patients fulfilling the inclusion and exclusion criteria were selected for the study and data were recorded in the CRF and formed questionnaires using patients case sheet files. Result:The study encompasses the total no of 120 patients having chronic kidney disease, of which men are found to be more prevalent than women accounting for (n=72) 60 % of the population. With regard to all age groups, those between 45 and 65 years old were the most impacted(n=66) 55%. Hypertension has been determined to be the most prevalent comorbidity, contributing to (n=113) 94.16% of all patients, contributing to the risk factors of chronic renal failure. based on formulated questionary for sign and symptoms out from different signs and symptoms such as fatigue, edema,anorexia, decreased urine output was found to be the most common and relevant sign among the all ckd stages (n=110) 91.66 %. stage G5 & G4 were higher compared to other stages due to associated risk factors such as advanced age & comorbidities with (n=84)70 % and (n=21)17.5 % respectively, contributing to highest no. of patients (n=89)74.16 % undergoing dialysis.Out of the total 998 drugs used, Antihypertensive Drugs are the most commonly used, followed by Haematinics and Drugs used for CKD such as (diuretics, drugs for acid base disorders,phosphate binders, drugs for electrolyte imbalance, and cholinergic agonist), with respective percentages of use of 21.41%, 19.42%, and 16.55%. CCBs with both reno and cardioprotective properties were the highest used antihypertensive drugs with 39.36 %. As there were many patients with end-stage renal disease, the prevalence of class diuretics was greatest overall, at 52.02% in drugs used for CKD. Conclusion: According to the results of our study, Chronic Renal Disease is primarily correlated with polypharmacy and comorbidities. The study site follows evidence-based practice along with Guidelines KDIGO.This study focused on to identifying the sign symptoms of disease based on various stages, risk factors, associated comorbiditiesand utilized drugs and it was found that males (60%) are found to be more prevalent, hypertension (94.16 %) is the most commonly found comorbid condition reflecting the highest utilization of antihypertensive drugs(21.41%)The burden of ESRD was higher due to existing comorbidities leading to increased risk of mortality and compromised renal outcome.