| Objective To explore the value of serum C1q tumor necrosis factor-related protein 9 (CTRP9) and vasohibin-1 (VASH-1) in evaluating early renal injury in patients with hypertensive disorder complicating pregnancy (HDCP). Methods A total of 112 patients with HDCP who were treated in Obstetrics and Gynecology Department, Hebei PetroChina Central Hospital from January 2022 to December 2022 were regarded as the study subjects and grouped into non-renal injury group (52 cases) and renal injury group (60 cases) according to whether renal injury occurred; in addition, 70 normal pregnant women were regarded as the control group. Enzyme-linked immunosorbent assay (ELISA) was employed to detect the serum levels of CTRP9 and VASH-1; Pearson was applied to analyze the correlation between serum CTRP9, VASH-1 levels and systolic blood pressure, diastolic blood pressure, tumor necrosis factor-α (TNF-α), blood uric acid and urine protein levels, multivariate logistic regression was applied to analyze the influencing factors of early renal injury in HDCP patients; ROC curve was used to analyze the value of serum CTRP9 and VASH-1 in the early prediction of renal injury in patients with HDCP. Results The levels of systolic blood pressure, diastolic blood pressure, TNF-α, blood uric acid, urine protein and VASH-1 in the renal injury group were higher than those in the non-renal injury group and the control group, and the level of CTRP9 (125.39±26.43) pg/mL in serum was obviously lower than that in non-renal injury group pg/mL and control group pg/mL (P<0.05); the serum CTRP9 level of HDCP patients with early renal injury was negatively correlated with systolic blood pressure, diastolic blood pressure, TNF-α, blood uric acid and urine protein levels (r=-0.474, -0.506, -0.487, -0.528, -0.534, P<0.05), while the serum VASH-1 level was positively correlated with systolic blood pressure, diastolic blood pressure, TNF-α, blood uric acid and urine protein levels (r=0.495, 0.524, 0.479, 0.506, 0.533, P<0.05); multivariate logistic regression analysis showed that high level of CTRP9 was an independent protective factor for renal injury in HDCP patients, and high levels of VASH-1, TNF-α, serum uric acid and urine protein were independent risk factors for renal injury in HDCP patients (P<0.05); ROC results showed that the area under the curve (AUC) of serum CTRP9 and VASH-1 in predicting early renal injury in patients with HDCP was 0.873 and 0.896, respectively, the AUC predicted by the combination of the two was 0.955, which was better than that predicted separately (Z=2.319, P=0.020; Z=1.755, P=0.079), the specificity was 92.31%, and the sensitivity was 86.67%. Conclusion The level of serum CTRP9 in HDCP patients with early renal injury is obviously lower, and the level of serum VASH-1 is obviously higher, both have certain potential value in early prediction and evaluation of renal injury in HDCP patients.