Aim To retrospectively investigate the relationship between the severity and long-term prognosis of coronary heart disease(CHD) and chronic renal failure (CRF). Methods 776 patients with CHD undergoing coronary artery stent implantation were selected. All patients were divided into two groups with or without CRF according to their basic kidney function level, among which 535 cases were in the CRF group and 241 cases were in the CRF-free group. Clinical characteristics, coronary artery lesions and 1-year incidence of major adverse cardiovascular events (MACE) were compared between the two groups. Results Compared with the control group, the degree of coronary artery stenosis in the CRF group was significantly worse, with more coronary artery number of lesions (P＜0.001) and higher proportion of coronary artery three-vessel lesions (P＜0.001) and higher gensini scores (P＜0.001). The 1-year MACE incidence was higher in the CDK group than in the control group (P=0.014). Multivariate Cox regression analysis showed that CRF was a risk factor for 1-year MACE occurrence. Conclusion CHD patients with CRF have more severe coronary artery stenosis, and CRF is an important index to predict the prognosis of CHD.