Objective:To observe the effect of atorvastatin on renal function and hemodynamics in elderly hypertensive patients. Methods:Fifty-six elderly hypertensive patients with hypertensive nephropathy were randomly divided into atorvastatin group(n = 29) and control group(n = 27), atorvastatin group was treated with atorvastatin for six months. The variation of blood pressure, low density lipoprotein cholesterol(LDL-C), alanine aminotransferase(ALT), creatine kinase(CK), creatinine, estimated glomerular filtration rate (eGFR), 24-hour urinary protein quantitation were examined, and the renal hemodynamics were observed by colour Doppler ultrasound before and after treatment. Results:LDL-C in atorvastatin group decreased significantly after 1 month or 6 months of treatment(P < 0.05). 24-hour urinary protein quantitation was unchanged in one month, and decreased significantly in 6 months in both groups(P < 0.05), which was lower in atorvastatin group than in control group(P < 0.05). Creatinine and eGFR were unchanged in both groups after 1 month of treatment,while in 6 months,creatinine decreased and eGFR increased in both groups, but no significant difference was achieved (P > 0.05), however, the difference was significant between two groups(P < 0.05). No significant difference was found in the peak systolic velocity (PSV) of bilateral renal artery (RA), segmental renal artery(SRA), leaves renal artery (IRA) in two groups before and after treatment. In the atorvastatin group, end-diastolic minimum flow(EDV) increased and resistance index (RI) of RA, SRA and IRA decreased significantly after 6 months of treatment (P < 0.05), significant difference was found between two groups (P < 0.05), especially for the difference of RA(P < 0.01). Conclusion:Atorvastatin have protective effect on renal in patients with hypertensive nephropathy. Reducing renal arteries resistance, improving renal vascular structure may be one of the renal protective mechanisms.