Objective To explore the early predictive value of blood urea nitrogen/creatinine ratio(BUN/Cr)combined with uric acid level for nephropathy in elderly hypertensive patients.Methods A total of 867 elderly hypertensive patients who underwent physical examination in the Health Management Center of the First Affiliated Hospital of Ningbo University from January 2022 to July 2022 were enrolled.During the one year's followed-up,hypertensive nephropathy developed in 44 cases(case group),and other 823 cases served as the control group.The blood pressure,blood urea nitrogen,creatinine,uric acid levels and urinary protein were compared between the two groups.The risk factors of hypertension nephropathy were analyzed by binary Cox regression.The value of BUN/Cr,uric acid and in combination for predicting hypertension nephropathy was analyzed by the ROC curve.Drew a constrained cubic spline to fit the nonlinear relationship between combined index and prognosis.Results The LDL-cholesterol,BUN/Cr and blood uric acid level in the case group were significantly higher than those in the control group(P<0.05).Cox regression analysis showed that the increase of BUN/Cr and blood uric acid level were independent risk factors of hypertensive nephropathy in elderly hypertensive patients.The AUC and Yoden index of BUN/Cr combined with blood uric acid for predicting hypertensive nephropathy were 0.736 and 0.587 respectively,which were higher than those of the two single indexes.Under the condition of node 4,the early combined index was nonlinearly correlated with the occurrence of elderly hypertensive nephropathy(P<0.05).Conclusion BUN/Cr and uric acid level can reflect the early renal function damage in elderly patients with hypertension to a certain extent.Applying the above two indicators,particularly the combination of two may be used for early predicting the risk of hypertensive nephropathy in this population.