Background: Hypertension (HTN) is one of the most important causes of chronic kidney disease (CKD) and may also be the presenting feature of asymptomatic primary renal disease. However, a progressive reduction in estimated glomerular filtration rate (eGFR) and increased albuminuria indicate progressive loss of renal function, an alteration of renal function is an insensitive marker of renal impairment because a major reduction in renal function is needed before serum creatinine rise. Low-grade inflammation plays crucial pathophysiological role in both hypertension and CKD. Objective: This work was aimed to study neutrophil-to-lymphocyte ratio (NLR) as a marker for early detection of hypertensive kidney disease and as a predictor of worsening renal function in patients with high normal blood pressure and in hypertensive patients. Patient and methods: This case control study included a total of 125 hypertensive patients and 50 subjects with normal blood pressure, attending at