الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Chronic renal failure is an irreversible disease of the kidney, characterized by a progressive chronic loss of renal functions that lead to ESRD. This disease showed marked increasing incidence in almost all countries all over the world in the last century. Many environmental parameters can be blamed as predisposing factors for the increase incidence of this disease. Among these factors are drinking water, food, air, housing conditions, drug abuse as well as some diseases that act as precipitating factors for the occurrence of this disease such as diabetes mellitus , hypertension and schistosomiasis. Drinking water always accused to be the main source for increasing incidence of chronic renal failure ,because it may contain higher levels of many metals used in our daily life and have adverse effects on the kidney. The aim of this, work was to study the magnitude of the problem of chronic renal failure in Alexandria, Egypt and to determine the important epidemiological factors related to the occurrence of the disease as well as , to correlate the role of drinking water and other sources of lead, cadmium, aluminum , and zinc with the disease incidence. The study also recorded the effects of other environmental risk factors among cases of chrQnic renal failure in Alexandria. The study was carried out on one hundred cases of chronic renal failure randomly collected from the following renal dialysis units in Alexandria: 1- Medical Research Institute. 2-Main University Hospital. 3-EI-Mowassat Hospital. 4-Shark EI-Madina Hospital. One hundred controls were matched for the age and sex and living under the same environmental conditions were tracked to the different districts of Alexandria City .Both groups were interviewed for their personal data and the different environmental variables usmg a prescheduled observation sheet. Data concerning the risk factors and general health were assessed via medical sheet that included complete history taking and medical examination. The blood and urine levels of lead, cadmium, aluminum and zinc were assessed in both of the studied groups using Atomic Absorption Spectrophotometer. Environmental sampling included 200 water samples taken from the houses of the cases and controls. One hundred sample were collected from the tap water of the chosen cases at the different districts of Alexandria City ( East, EI-Montaza, Middle, West ,EI-Gomrok and El Amerya) . Another one hundred samples were collected at random from the tap water of the controls living at the same districts. The water samples were subjected to routine physical and chemical analysis together with the determination of