Background: Prevalence of hearing loss in chronic kidney disease is between 40â€“60%. Its pathomechanism has not been fully understood but could be related to temporal bone remodeling. The bone metabolism disorder in chronic kidney disease is also manifested in vitamin D deficiency. Purpose: This study aims to learn the correlation between otic capsule density and serum 25(OH)D with a hearing threshold in chronic kidney disease without hemodialysis. Method: An observational analytic study with a cross-sectional design involving 36 patients with stage 3 and 4 chronic kidney disease Hearing was examined with Interacoustics AA222 audiometer, otic capsule density was measured using Toshiba Aquilion 128 CT while vitamin D was assessed by ELISA using ORGENTEC 25-OH Vitamin D3/D2 Assay kit. Hearing loss was defined as a hearing threshold over 25 dB on the better hearing ear. Results: Hearing loss was found in 17 of 36 subjects (47.2%). On independent sample t-test, ears with HL(n=44) has lower otic capsule density than ears without (n=28) significantly (p< 0.05; ROI1: 1.867 Â Â± 285 vs 2.095 Â Â± 315 HU; ROI2: 1.864 Â± Â 190 vs 2.051 Â Â± 293 HU). Pearson test showed a significant negative correlation between otic capsule density and hearing threshold (p<0.05; ROI1: r=-0.427; ROI2: r=-0.402). Serum 25(OH)D was insignificantly lower in a subject with HL(n=17) than without (p>0.05; 16.45 Â Â± 6.33 vs. 17.99 + 10.57 ng/mL) and no correlation was found to a hearing threshold in chronic kidney disease. Conclusion: Significant correlation was found between otic capsule density and hearing threshold in predialysis chronic kidney disease. There were no correlation between serum 25(OH)D and hearing threshold and therefore unsuitable as a biomarker for the aforementioned condition.