OBJECTIVES: Cost unaffordability is one of the major reasons for the deprived quality of life and increased mortality in chronic kidney disease (CKD) patients especially in patients on dialysis. However, very limited data is available on CKD cost of illness (COI). This study was carried out to estimate the cost of illness in the patients of CKD. METHODS: This cross sectional study was carried at a renal clinic of a tertiary care hospital over a period of six months. COI was estimated as the sum of the direct and indirect cost involved. Direct cost was divided into direct medical and direct non-medical cost. Direct medical cost included the acquisition cost and ancillary cost. Direct non-medical cost included the cost of transportation & food. Indirect cost included the loss of productivity as a result of absence from work by patients and care givers. Five stages of CKD patients were divided into two groups (G1-G4, and G5), according to KDIGO guidelines. Costs were estimated in terms of Indian national rupee (INR; IUSD~INR62). RESULTS: A total of 122 patients were included in the study (65, 57 in G1-4 and G5 groups, respectively). The mean±SD age of the patients was 52.9±7.8 years. Mean±SD monthly cost of illness for the patients on in G1-4 stages and G5 stage were INR 7882±945 ($127) and INR 13882±1687 ($224), respectively. The mean±SD monthly COI for the patients on dialysis was INR 32171±950 ($519). Of total expenditure 55.4% were spent directly for treating illness (out of pocket expenditure). On average a patient on dialysis had spent 3.9 lakh INR per year ($6291). Through analysis of sub-groups of patients, it was found that funding from employer/ Insurance, dialysis, lower socioeconomic status, lower education, comorbidities and rural residential have a major impact on COI in patients of chronic kidney disease. CONCLUSIONS: Monthly cost of illness for the patients in G1-G4 and G5 were INR 7882 ($127) and INR 13882 ($224). The study is in progress.