Introduction: Chronic kidney disease (CKD) is a recognized global public health issue. The burden of CKD is even greater in developing countries like India as compared to developed countries. CKD affects multiple organ systems, including the auditory system. The cochlea and kidney also share certain anatomical resemblance at an electron microscopic level and similar antigens. Materials and methods: A cross-sectional observational study with sixty CKD patients and 20 age-matched controls to establish a relationship between stage 3, stage 4, and stage 5 of CKD and degree of hearing loss. These patients underwent a complete clinical evaluation, including blood investigation and audiometry, and categorized into stages 3, 4, and 5 of CKD based on estimated glomerular filtration rate values and compared to the control group. Results: The most common etiology identified was hypertensive CKD affecting 42 cases. Tinnitus was the most common symptom. The pure-tone audiometry (PTA) findings of both ears showed increased hearing thresholds in CKD patients as opposed to the control group. As the disease progressed from stage 3 to stage 5, the hearing loss also increased across all frequency. A significant correlation between duration of disease and mean PTA of patients was noted in our study. As the disease progressed from stage 3 to stage 5, distortion-product otoacoustic emissions (DPOAE) sound noise ratio values in both ears decreased, indicating cochlear hypofunctionality across all frequencies. Conclusion: We suggest a routine DPOAE evaluation at least once in 6 months for patients who are newly diagnosed or are receiving treatment for CKD to pick up outer hair cell abnormality early.