Background: Chronic kidney disease (CKD) has a high prevalence around the world, which contributes to significant morbidity and mortality rate, and a huge expenditure is spent on CKD management, and it poses an enormous threat to public health. Objective: The present study investigated the association of serum copeptin concentration with healthy volunteers as a control, CKD stage 3 with heart failure, CKD stage 3 and CKD stage 4 and 5 groups. Methods: This study was designed to be a Cohort study, in which data were collected prospectively. Seventy-two chronic kidney disease individuals at different stages early stage (CKD 3a and 3b), advanced stage (CKD4 and5) and CKD with heart failure (CKD 3b) and 15 unrelated healthy individuals were included in this study. The important clinical characteristics of study participants such as haemoglobin ( Hb), serum albumin, total cholesterol, triglycerides, calcium, phosphorus, uric acid and copeptin level were measured using standard protocols. Results: We found that the serum copeptin concentration was significantly associated with the CKD stage 3 with heart failure, CKD stage 3 and CKD stage 4 and 5 groups. Further, the significant correlation was also observed between the serum copeptin and e GFR, creatinine, BNP and Copeptin/ creatinine, copeptin*BNP/ creatinine, and copeptin/ eGFR ratio, LVDd and LVMI. Conclusion: In conclusion, the serum copeptin increased in patients with CKD with decreasing e GFR and also in patients with CKD and heart failure (EF __ampersandsignlt;40%). There was a significant association of serum copeptin between groups 2, 3 and 4.