ABSTRACT
Renal artery stenosis now is one of the well recognized causes of Ischemic nephropathy and arterial Hypertension. It is one of the most challenging fields in medicine. Like other vascular anomalies, renal artery stenosis does not always have clinical outcomes. Renal artery stenosis can be seen with accompanying of other vascular abnormalities like arterial duplication, but stenosis of all supplying arteries together is rare. Patient is a 65 years old man, known case of poor control hypertension, chronic renal insufficiency and CVA, presented with diarrhea, repeated vomiting and deterioration of renal function. After clinical evaluation, patient underwent renal angiography and with bilateral duplication and renal arteries stenosis in all four arteries, and then angioplasty was per formed. Renal function returned to normal and blood pressure controlled