Background: Gastrointestinal mucosal lesions are widespread in chronic kidney disease, end-stage renal disease, and in prerenal transplant period. H. pylori infection is more common in uremic patients. Our study aimed to compare UGI endoscopic findings between uremic patients and renal transplant recipients. Methods: A cross-sectional study on 148 patients that were carried out in the Gastroenterology and Hepatology Unit, in Internal Medicine Department, and Nephrology department, Zagazig university hospitals from Jan 2023 till July 2023. We included patients with CKD classified according to eGFR. All patients underwent a clinical examination and a full history taking, Upper GIT endoscopy, Laboratory Investigations included CBC, KFT, LFT, eGFR and H. Pylori Ag in stool. Results: Out of the 148 Patients, males were 88(59.5%) and females were 60(40.5%). The predominant Endoscopic finding found was erosive gastritis (35.1%), Majority of the subjects found in stage III and least was esophagitis (1.4%). According to indication of endoscopy we found 33.1% of subjects done for epigastric pain and 10.8% done as pretransplant preparation. There was a noteworthy distinction between the 5 groups regarding Urea and Creatinine with higher levels in the advanced grades. The presence of H. Pylori did not significantly differ between the groups. Conclusions: most patients with chronic renal disease had upper GI involvement. Erosive gastritis is the most common findings in our study found in stage III. Fatal complications such severe upper GI bleeding can be avoided with early diagnosis and treatment, which can also lower morbidity and mortality.