Back ground: Chronic Kidney Disease (CKD) is the most common health related problem. Poor long term adherence is the major clinical issue in the management of CKD. Therefore good medication adherence is important to obtain desired therapeutic outcome which in turn improves the quality of life of the patient. The aim of the study is to carry out a study on medication adherence and to improve health related quality of life in patients with CKD. Objectives: To evaluate medication adherence and to assess the factors associated with non adherence and to provide patient counselling to improve medication adherence and to improve their quality of life. Methods: A prospective study conducted for a period of six months in NU Hospitals Bengaluru. A total of 140 patients (62 were undergoing hemodialysis, 66 were CKD stage 3-5 and 12 were post-transplant patients) were enrolled for the study. Patient’s adherence to medication was assessed with the help of Modified Morisky, Green, Levine Medication Adherence Scale and Quality of life was assessed with the help of Kidney Disease Quality of Life-Short Form 36 questionnaire. One to one follow up was done after 3 months of initial data collection. Results: During the study 140 patients were enrolled for the study with 103 males and 37 females. Patient with low and medium adherence during the first visit were 7 (5%) and 21 (45%) respectively and patients with high adherence during baseline visit were 80%, which later improved to 85.7% in the final review after patient counselling. Quality of life is decreased in patients with CKD. The domain with highest average score was emotional well being (8.4) and lowest average score was role limitation due to physical health (4.12). There was a slight improvement in Quality of Life of the patients after patient counselling. Conclusion: Study suggests that patient counselling by clinical pharmacists can improve the medication adherence by improving awareness about medication which in turn helps them to achieve a better quality of life.