Background Many studies were performed for thyroid dysfunction in CKD patients and had very variable prevalence. Therefore, we make the decision to determine the most significant predictors of hypothyroidism in patients with CKD under various treatment methods in our area and to estimate the prevalence of hypothyroidism in such patients. Patient& Methods: 200 CKD patients were included in this study, subdivided into 2 groups; 120 conservatively treated and 80 hemodialysed patients . All patients underwent a clinical examination, a detailed history, routine investigations, and the MDRD equation was used to estimate their eGFR. The enzyme-linked immunosorbent assay (ELISA) was used to quantify Thyroid Stimulating Hormone (TSH), free T3, and free T4. Results: Among 200 patients; 10.5% had subclinical hypothyroidism , and 2% had overt hypothyroidism, with no significant prevalent difference between the two modality of treatment, Significant positive correlation was found between TSH versus CKD duration and age of CKD patient's in the two modality of treatment, and between TSH versus serum Phosphorus in conservatively treated group Binary regression analysis revealed that increasing serum phosphorus and CKD duration increase risk of hypothyroid dysfunction by 1.471 and 1.442 fold in conservatively treated and by 1.826 and 1.542 fold in hemodialysed patients respectively Conclusion: Hypothyroidism is common in CKD patients in our locality with no significant difference between the two modality of treatment..Serum phosphorus and age of CKD patients could be independent predictors of hypothyroidism in those patients.