Abstract: AIM: To investigate the relationship between homocysteine, serum cystatin and early renal impairment in patients with hypertension. METHODS: One hundred and fifty-three patients from our hospital meeting the inclusion criteria from June 2011 to July 2013 were included in the study. Isotope renogram was performed to measure the kidney glomerular filtration rate (GFR). Patients were divided into two groups according to GFR results: nonimpaired renal function group and impaired renal function group. Serum Cystatin-C, 24h MAU, creatinine (SCr) and blood urea nitrogen (BUN) were also measured and the correlation between GFR and Hcy, Cys-C was analyzed. RESULTS: Statistical differences were found in homocysteine and Cys-C between groups and Pearson correlation analysis showed that GFR was negatively correlated with homocysteine, Cys-C, SCr and BUN (all P<0.01). Multiple regression analysis showed that homocysteine and Cys-C were independent risk factors for GFR with partial regression coefficient β, respectively, -2.015 (P<0.05) and -5.448 (P<0.01). CONCLUSIONS: Homocysteine and Cys-C are closely correlated with early renal impairment in essential hypertension.