Abstract: Pleural effusion is a common complication in chronic kidney disease (CKD) patients undergoing hemodialysis. This study aimed to evaluate the relationship between pleural effusion location with pleural fluid characteristics and adenosine deaminase (ADA) levels in hospitalized CKD patients. While ADA levels were higher in exudative effusions, no significant association was found between effusion location and pleural fluid composition. These findings suggest that effusion location alone is not a reliable diagnostic indicator in CKD patients.