BACKGROUND: Hypertensive nephropathy is increasingly prevalent and a leading cause of end-stage renal disease. Current treatment strategies for hypertensive nephropathy focus on blood pressure control and reducing urinary albumin. However, the use of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) medications carries risks, including a potential decrease in glomerular filtration rate (GFR). This report aims to assess the clinical effectiveness of Quanduzhong capsules (QDZCs) in early-stage hypertensive kidney damage, contributing to the evidence base for their use in traditional Chinese medicine for hypertension treatment. METHODS: The patients, two middle-aged gentlemen with over a decade of hypertension in their medical history, were currently in the early phase of grade 1 hypertension. Notably, their blood pressure readings consistently exceeded the normal parameters. Furthermore, they exhibited signs of microalbuminuria and proteinuria in their clinical presentations. Based on these symptoms, they received a diagnosis of hypertensive kidney damage, specifically at the microalbuminuria stage. RESULTS: After admission, the two patients took QDZCs for treatment. The medication method was: 2 times a day, 3 capsules each time. The results showed that the microalbuminuria of case 1 and the proteinuria of case 2 were reduced within 12 weeks after taking the medicine, and the average 24-h blood pressure was also reduced. Case 2 experienced a slight decrease in creatinine clearance and glomerular filtration rate after treatment, but the difference was not significant. During the 12-week follow-up period, there were no significant abnormalities in serum creatinine, blood urea nitrogen, creatinine clearance, and estimated glomerular filtration rate. CONCLUSION: This case report shows that Quanduzhong capsule can lower blood pressure and improve symptoms of microalbuminuria and proteinuria in patients with early hypertensive renal damage, and may provide a promising treatment option for the management of early hypertensive renal damage. However, the evidence is preliminary and larger, controlled studies are needed to determine its efficacy and potential advantages.