Inflammatory cytokines like IL-18 and anti-inflammatory cytokines like IL-37 are both involved in the etiology of ESRD and comorbidities including hypothyroidism. Despite the fact that Subclinical Hypothyroidism is common in people with chronic kidney disease, little is known regarding the clinical signs and implications of this ailment in patients with end-stage renal disease. The purpose of this study was to assess the role of Interlaken-18 (IL-18) and Interlaken 37 (IL-37) in end-stage renal disease (ESRD) and to establish the prevalence of hypothyroidism (both subclinical and overt hypothyroidism) in patients with ESRD. In the study, 598 hemodialysis patients of both genders were included. This study included 104 male and female hemodialysis patients (82 with subclinical hypothyroidism and 22 with overt hypothyroidism) and 60 healthy people as a control group. All participants' venous blood was drawn in the morning while they were fasting (8 hours) and subjected to clinical evaluation and laboratory testing. The enzyme-linked immunosorbent assay technique was used to quantify serum IL-18 and IL-37 in all of the study participants. When compared to the control group, the prevalence of IL-18 and IL-37 was higher in Subclinical Hypothyroidism and overt hypothyroidism (p≤0.001). Early diagnosis of Subclinical Hypothyroidism, which was discovered in 23% of patients with ESRD, may reduce the risk of cardiovascular events and the progression of kidney disease, according to the study. In ESRD patients with hypothyroidism, blood levels of both IL-18 and IL-37 are significantly elevated. In overt hypothyroidism, serum IL-18 and IL-37 levels are higher than in subclinical hypothyroidism.