Abstract: To analyze the correlation and clinical expression significance of ultrasound parameters, serum aldosterone（ALD） and Renin levels with renal function in patients with hypertension, a total of 99 patients with hypertension in Fuyang hospital affiliated to Anhui medical university from March 2020 to January 2021 were selected,and 43 of them with early renal damage were selected as the group of renal damage, and the remaining 56 cases were set as the group without kidney damage. After admission, two blood samples were taken to determine serum ALD and Renin levels, and an ultrasound examination was performed. Counting the ultrasound parameters interlobular artery pulsatility index（PI）, resistance index（RI）, serum ALD, Renin, and renal function indexes urine neutrophil gelatinase-associated apolipoprotein（NGAL）, kidney injury molecule-1（KIM-1） of the two groups. Urine NGAL, KIM-1 measurement results divided by urine creatinine（Cr） as the final measurement results, the corre lation between ultrasound parameters, serum ALD, Renin levels and renal function indexes, early renal damage and the predictive value of early renal damage in hypertension were analyzed. The levels of serum ALD, Renin, PI, RI,urinary KIM-1/Cr, NGAL/Cr in the renal damage group were higher than those in the non-renal damage group（P＜0.05）. Pearson correlation analysis showed that serum ALD, Renin level, PI, RI values of patients with hypertension were positively correlated with urine KIM-1/Cr and NGAL/Cr levels（P ＜0.05）. Logistic regression analysis showed that serum ALD, Renin, PI, and RI were important risk factors for early renal damage in patients with hypertension（P＜0.05）. The sensitivity of serum ALD, Renin, PI and RI to predict early renal damage in hypertensive patients was 81.40%, and the specificity was 87.50%. Ultrasound parameters, serum ALD and Renin levels have a significant correlation with renal function in patients with hypertension, and can be used to predict early renal damage in patients with hypertension.