Assessment of the thyroid nodularity, thyroid volume and morphological changes (using ultrasonography) in a random sample of hemodialysis patients. Design/Methods: A cross-sectional study of 60 CKD patients stage 5 on hemodialysis with an estimated glomerular filtration rate (eGFR) below 15 ml/min/1.73m2. Patients from Cairo university hospital - nephrology clinic and hemodialysis unit While Control group involved sixty age-matched normal persons –with normal serum creatinine and eGFR - will be included in the study as a control group for the thyroid nodularity and volume. Results: Mean Thyroid volume is significantly increased in end stage renal disease (ESRD) patients 9.98 ml compared to that of controls 8.38ml with significant P value (0.007). The percent of renal patients with thyroid nodules is higher in ESRD than control. It was 30% (18 cases) in ESRD group while it was 18.3% (11 cases) in control with p value 0.349. Conclusion: Increased thyroid volume and nodularity are more common in HD patients compared with controls