الفهرس 
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Abstract
Renal artery stenosis (RAS) usually refers to a disease of the large extra renal arterial vessels and most frequently is caused by atherosclerotic obstructions. Atherosclerotic renal artery stenosis (RAS) causes cardiorenal problems. The prevalence of atherosclerotic RAS increases with age, male gender and traditional cardiovascular risk factors which the most important according to our study (HTN, diabetes and dyslipidemia) and in particular the aortoiliac occlusive disease). However, the true prevalence of atherosclerotic RAS in unselected patients is unknown. In hypertensive patients’ population, a significant RAS is observed in less than 5% of the patients. It has been emphasized that there was common association of renal artery stenosis with atherosclerotic disease in other vascular beds. The renal artery stenosis in patients undergoing routine cardiac catheterization has been found in percentage of those patients with stablished CAD. The aim of the study was to study the incidence and predictors of renal artery stenosis in patients with multivessel coronary artery disease. This prospective observational study was carried out at Tanta University Hospital in the period from December 2018 to February 2020. This study included (100) patients with multivessel stable coronary artery disease undergo bilateral renal angiography. All patients gave an informed consent to participate in the study. Studied patients were divided into three groups according to the presence of renal artery stenosis as follows: group I: Normal renal arteries. • group II: Non-significant renal artery stenosis • group III: Significant renal artery stenosis. After admission to the hospital, each patient was subjected to: 1. Full history taking. 2. Through physical examination. 3. Electrocardiography 4. Trans-thorathic echocardiography (TTE) 5. Laboratory investigations • Urea and creatinine level measurement. • Fasting, post prandial blood sugar and HbA1C levels • lipid profile 6. selective left and right coronary arteriography using the standard technique 7. selective renal arteriography was performed Our study population contains 76 % male and 24 % female, their Ages in the studied was ranged from 32 to 77 years old with Mean age 56.45±9.579. Also, in characteristics of our studied patients there was 57 patients were diabetic, 56 patients were hypertensive, 44 were smoker (current and exsmokers), 56 patients were had dyslipidemia and 23 patients had positive Family history of CVD Previous PCI was documented in 14 % in the studied population while CABG was noted in 12% During our study we found that of incidence of renal artery stenosis diagnosed generally in 27 patients of total 100 patients. Differentiated according to severity to 73 patients had no RAS, 17 patients had non-significant RAS and 10 patients had significant RAS. Our study showed that there was a statistically significant difference regarding age, hypertension and diabetes, Dyslipidaemia and CABG history between groups. Number of vessels affected also showed a statistically significant difference between groups. A multivariate Binary logistic regression model was performed to ascertain the effects of HTN, DM, age and Dyslipidemia on the likelihood that participants would have RAS. The results showed that: DM [odds ratio (OR) =7.203; 95% ,,confidence interval (C.I) = 1.750 – 29.645; p=0.006]. , HTN [odds ratio (OR) =4.101; 95% ,,confidence interval (C.I) = 1.066 – 15.771; p=0.040] and older age [odds ratio (OR) =1.149; 95% ,,confidence interval (C.I) = 1.046 – 1.262; p=0.004] were a predictors for incidence of RAS among our studied population While dyslipidemia was not a predictor for RAS in the studied population [odds ratio (OR) =3.594; 95%, confidence interval (C.I) = 0.935 – 13.548; p=.