Abstract: Objective To investigate plasma homocysteine(Hcy) levels and early renal damage in essential hypertension in ethnic Uyghurs and Hans patients,and to explore the difference of early renal damage in the two ethnics. Methods Eight hundred and twelve cases with essential hypertension were included and divided into two groups:H-type hypertension group(Hcy ≥ 10 μmol/L,254 cases were Uyghurs and 294 cases were Hans) and non H-type hypertension group(Hcy<10 μmol/L,149 cases were Uyghur and 115 cases were Hans).The plasma levels of Hcy and creatinine were measured.The correlation between Hcy and early renal damage and the difference of early renal damage in the two ethnics were analysed. Results Compared with the non H-type hypertension group,the levels of creatinine,cystatin C,and the early renal damage prevalence were statistically higher in H-type hypertension group in both ethnic Uyghurs and Hans(P<0.05),while eGFR was significantly lower(P<0.05).There were no difference of early renal damage prevalence in the two ethnics in both H-type hypertension group and non H-type hypertension group(P>0.05).Logistic regression analysis indicated that LnHcy(OR=2.201,95% CI:1.066-4.543,P=0.033),cystatin C(OR=1.475,95% CI:1.303-1.699,P<0.001),low HDL-C(OR=2.475,95% CI:1.436-4.268,P=0.001),BUN(OR=1.277,95% CI:1.054-1.547,P=0.013) were independent risk factors for early renal damage in essential hypertension among ethnic Uyghurs.While LnHcy(OR=3.804,95% CI:1.855-7.798,P<0.001),cystatin C(OR=1.655,95% CI:1.433-1.911,P<0.001),low HDL-C(OR=2.059,95% CI:1.208-3.509,P=0.008),BUN(OR=1.222,95% CI:1.018-1.468,P=0.032),cigarette(OR=1.993,95% CI:1.082-3.671,P=0.027) were independent risk factors for early renal damage in essential hypertension among ethnic Hans. Conclusion Plasma levels of Hcy is associated with early renal damage in essential hypertension in both ethnic Uyghurs and Hans patients,there were no difference of early renal damage prevalence in the two ethnics.