Aim To investigate the association of early renal impairment with four arterial stiffness indexes derived from ambulatory blood pressure monitoring （ABPM），and to provide comparison result between parameters in detecting the renal impairment of essential hypertension. Methods The 253 essential hypertensive patients were enrolled.The 24 hours mean pulse pressure （24h PP），pulse pressure index （PPI），ambulatory arterial stiffness index （AASI），symmetrical ambulatory arterial stiffness index （S-AASI），urine microalbumin to creatinine （mA1b/Cr） and estimated glomerular filtration rate （eGFR） were collected. Partial correlations and multiple stepwise regression analysis were performed to confirm the relationship between parameters of ABPM and renal lesion. The predictive power of four arterial stiffness parameters for early renal impairment was accessed by ROC curve. Results Correlation test showed a significant positively relationship of 24h PP，PPI，AASI，S-AASI with mA1b/Cr （r0.470，0.448，0.613 and 0.632 respectively，P<0.05），and eGFR were negatively correlated with them （r－0.308，－0.254，－0.399 and －0.352 respectively，P<0.05）. Multiple linear regression analysis also showed independent correlation in 24h PP，PPI，AASI，S-AASI with eGFR. Area under ROC curve of S-AASI，AASI，24h PP and PPI were 0.692，0.686，0.681 and 0.655 respectively. The accuracy of the diagnosis was medium. The highest sensitivity was observed for S-AASI and PPI was with the highest specificity. Conclusion This study can support the idea that the four arterial stiffness parameters derived from ABPM had the similar ability to estimate hypertensive renal impairment.