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Background: Diagnosing chronic kidney disease (CKD) in clinical practice is quite difficult for patients presenting with uremia for the first time. Carbamylated haemoglobin (CarHb) may provide a better index of chronic uraemic exposure than a single measurement of urea. Objective: To evaluate the carbamylated haemoglobin as an early biomarker in the diagnosis of CKD. Methodology: This prospective observational study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2019 to December 2019. A total of seventy (70) patients with renal impairment were enrolled. On the basis of developing CKD the study population was divided into two groups- group A (CKD) and group B (Non CKD). Relevant investigations like- urine routine microscopic examination, 24 hours urinary total protein, blood urea, serum creatinine, serum electrolytes, complete blood count, serum albumin, serum calcium, serum phosphate, serum parathyroid hormone, carbamylated haemoglobin levels and renal ultrasonography were done. These investigations were repeated in each patient after 3 months to define CKD according to KDIGO guideline. All data were analyzed and compared by statistical tests. Results: Among total 70 study subjects, 15(21.4%) patients had CKD and their mean age was 54.47(±11.84) years. Carbamylated haemoglobin (CarHb) level was significantly higher (107.2±9.3 µgVH/g Hb versus 86.2±15.2 µgVH/g Hb; p

36-years old man presenting with the complaint of sudden severe upper abdominal pain, vomiting and polyuria with raised serum creatinine (2.74 mg/dl), serum calcium (19.68 mg/dl) and intact parathyroid hormone (iPTH) (2014.70 pg/ml) level. His ultrasound image of neck region demonstrated hypoechoic mass (12×10 mm) at left inferior parathyroid gland. Parathyroid schintography reported positive for parathyroid adenoma (left lower). He underwent medical management followed by parathyroidectomy. Optimum serum calcium concentration is essential for homeostasis and function of multiple organ systems. Severe hypercalcaemia is rare but life threatening complication of primary hyperparathyroidism (PHPT). In order to prevent mortality, it is necessary to provide immediate appropriate treatment by correcting hypercalcaemia and dehydration.