Background: CKD related hyperphosphatemia is associated with CKD mineral and bone disorder (CKD-MBD), which has a high rate of disability among patients especially in the elderly, abnormal rise of serum phosphorus eventually leads to cardiovascular disabilities, left ventricular hypertrophy in patients who are on hemodialysis. Non-calcium, non-metal based phosphate adhering agent that can retard absorption of phosphate from alimentary canal thereby reducing serum phosphate level can prove to be more useful, one such agent is sevelamer hydrochloride. Objective: To study the serum concentration of phosphorus in patients who were known case of chronic kidney disease from stages 3rd to 5th and their clinical profile and therapeutic outcomes with the drug sevelamer hydrochloride. This study also aims to highlight the role of sevelamer hydrochloride in CKD (3-5) and reduce the burden of hypertension (HTN), and chronic kidney disease (CKD). Methodology: Single centered, prospective observational study was conducted in a tertiary care hospital. It was conducted over a period of 6 months. A total of 64 patients were involved in the study, and data were collected through patient data collection form, treatment chart or case sheet and interaction with the patient. Results: Among recruited patients 46.03% were male and 53.96% were female, the majority was between 35-65 years of age. The 4th and 5th stage of CKD was seen in the majority of the subjects. Conclusion: Sevelamer hydrochloride is effective even in an elderly patient; diabetic sluggish retardation may be boon with sevelamer hydrochloride but may hinder the effect of other drugs that reduce serum creatinine levels and improves GFR.