Chronic kidney disease is defined as a condition associated with persistent abnormality in kidney structure and function for more than 3 months duration.CKD is a global problem,16 th most common cause of mortality worldwide effecting 8-16% of population. Neutrophil to lymphocyte ratio, Monocyte to lymphocyte ratio and platelet to lymphocyte ratio help in prediction of outcome in CKD, cardiovascular diseases, rheumatic heart disease. So the present study is done to observe the Neutrophil to lymphocyte ratio, Monocyte to lymphocyte ratio and platelet to lymphocyte ratio help in prediction of outcome in CKD. A cross sectional study 82 patients for a duration of 18 months. Patients of age >18 years who were on hemodialysis for > 3months duration presented to department of Medicine, VMMC, Karaikal were included in the study. The study revealed that on comparison of sensitivity, specificity of NLR, MLR, PLR and PTH with overall mortality rate p-value of MLR with overall mortality rate is 0.039 which is statistically significant and the p-value of PTH with overall mortality is 0.030 which is statistically significant. In the present study, we established an inflammation scoring system by including NLR, MLR and PLR. We found that higher inflammation score was independently associated with all-cause mortality in HD patients. Traditionally used CRP levels doesn’t have any significant association with all-cause mortality.