Coronary artery disease is widely prevalent among patients with end stage renal disease, it is the main cause of myocardial morbidity and mortality. There are many risk factors that lead to this increased prevalence that could be classified into: 1-traditional risk factors 2- non-traditional risk factors.Myocardial perfusion imaging (MPI) could be used efficiently to detect CAD in these patients as the clinical trials have proven its high sensitivity which is concordant with the current study.