Objectives To investigate the relationship between small reductions in estimated glomerular filtration rate (eGFR) and cardiac structure and function in patients with essential hypertension. Methods The study group included 565 patients with essential hypertensive. eGFR was calculated by EPI equation and cardiac structure and function were assessed using echocardiography. The participants were divided into three groups: eGFR ≥90 mL/min /1.73 m2, 60-89 mL/min/1.73 m2, and 30-59 mL/min /1.73 m2. Pearson correlation analysis and multiple stepwise linear regression analysis were performed to evaluate associations between eGFR and echocardiogram parameters. Results Compared with patients with eGFR ≥ 90 mL/min/ 1.73 m2, those with eGFR 60-89 mL/min/ 1.73 m2 and 30-59 mL/min/ 1.73 m2 had higher left ventricular end-diastolic diameter (LVEDD) (p=0.019), mitral valve E wave (p=0.004), left atrial diameter (LAD) (p=0.001), right atrial diameter (RAD) (p=0.001), right ventricular diameter (RVD) (p=0.001) and lower left ventricular ejection fraction (LVEF) (p=0.01). After further adjustment for traditional cardiovascular risk factors including systolic and diastolic blood pressure, BMI, diabetes, dyslipidemia and smoking, eGFR was still associated with LVEF (p＜0.001), LAD (p＜0.001) and RAD (p=0.003). Conclusion Among patients with essential hypertension, even mildly reduced renal function is independently associated with greater cardiac remodeling, indicated by left atrial and right atrial enlargement, and worse left ventricular systolic function.