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Abstract The risk for CVD in a 30-yr-old ESRD patient is similar to the calculated risk of a 70 to 80-yr-old subject from the nonrenal population. Traditional and non traditional risk factors all common phenomena of ESRD that may promote atherosclerosis. The diagnosis of CHD in patients with and without renal failure is the same but atypical clinical presentation is more common in ESRD. Also the serological diagnosis of AMI may also be more difficult in patients with end-stage renal disease because of false positive elevations in creatine kinase (CK) and troponin T. Ptients on dialysis should undergo initial and regular evaluation for CHD involving ECG, stress echocardiography, nuclear imaging and angiography according to their condition and circumstances. Anaemia and hypertention should be corrected. Many strategies were used in treatment of CHD in ESRD 1- Medical therapy 2-Thrombolytic agents 3-Invasive management |