BACKGROUND AND AIMS The role of cardiac biomarker, NT-pro-BNP and its rising over time may identify chronic kidney disease (CKD) patients at increased risk of cardiovascular morbidity and mortality. Additionally, this may be correlated with altered cardio-metabolic risk factors predicting adverse outcomes. In this study, serum NT-pro-BNP level at different stages of CKD patients was measured to observe its association with different cardiac and metabolic risk factors METHOD This was a cross-sectional study carried out on stable CKD patients, stages 1–5, attending the outpatient department of a tertiary renal care facility. Serum creatinine, estimated glomerular filtration rate (eGFR) and urinary ACR were measured as renal function tests. While cardio-metabolic risk factors included blood pressure, body mass index (BMI), lipid profile, serum albumin, uric acid and hsCRP. Statistical analyses of the results were obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). RESULTS Patients of CKD 5 (30%), stage 4 (23%), stage 3 (26%), stage 2 (18%) and in stage 1 (6.7%) included 149 subjects. In stages 1–5 respectively, they were matched for age 48 ± 12, 48 ± 12, 51 ± 14, 50 ± 12, and 50 ± 11 years, (P = NS); BMI 24 ± 0.9 24 ± 1, 24 ± 1, 24 ± 1 and 24 ± 1 kg/m2, (P = NS) and serum creatinine was variable as 1.5 ± 1.5, 1.7 ± 0.7, 2.6 ± 2.0, 3.0 ± 1.6 and 5.7 ± 2.7mg% (P < 0.001). The mean NT-proBNP had a rising pattern in stages 1–5 showing 335 ± 674, 790 ± 1717, 1221 ± 1994, 2875 ± 6139 and 15645 ± 14741 pg/mL, (P < 0.001). There were positive correlations of NT-pro-BNP with serum creatinine (P < 0.001); CKD stages (P < 0.001). TG (P < 0.003); phosphate (P < 0.008) and negative correlation with serum albumin (P < 0.001). CONCLUSION Higher levels of NT-pro-BNP are seen in advancing stages of CKD. The positive association of NT-pro-BNP with lipids, phosphate and negative relation with albumin indicates its possible prognostic value for cardio-metabolic risk assessment.