Abstract: Objective The precious studies have proved that the monotherapy of telbivudine（LDT） or adefovir dipivoxil （ADV） can influence the estimated glomerular filtration rate（eGFR）. The aims of this study is to assess the effects of combination therapy based on ADV on renal function in patients with chronic hepatitis B （CHB）. Methods The clinical data of 164 patients with CHB in the Department of Infectious Disease，Second Affiliated Hospital，Dalian Medical University between February 2007 and October 2015 were retrospectively analyzed. The study included treatment of entecavir （ETV） combined with ADV（n=42），lamivudine （LAM）combined with ADV（n=68），and telbivudine（LDT） combined with ADV（n=54）. We compared the changes of serum creatinine（sCr），eGFR and we analyzed the risk factors affecting eGFR changes in the patients by Logistic analysis. Results At the end of 104 week treatment， serum sCr level in the group of ETV combined with ADV increased as compared to that at baseline（73 μmol/L versus 67 μmol/L，P=0.012），it alse increased in LAM combined with ADV group（79 μmol/L versus 68 μmol/L，P=0.008），while it decreased in the group of LDT combined with ADV（64 μmol/L versus 69 μmol/L，P=0.023）；The eGFR in the group of ETV combined with ADV decreased （96.1 ml·min^-1·1.73 m² versus 107.8 ml·min^-1·1.73 m²，P=0.004），it alse decreased in LAM combined with ADV group （87.3 ml·min^-1·1.73 m² versus 105.4 ml·min^-1·1.73 m²，P=0.000），however， the eGFR in the group of LDT combined with ADV increased （104.1ml·min^-1·1.73 m² versus 116.2 ml·min^-1·1.73 m²，P=0.005）；the proportion of patients with normal renal function in the group of LDT combined with ADV was higher than that in the group of LAM or ETV combined with ADV（P=0.002，P=0.001）；Logistic analysis showed that age，gender，the baseline eGFR，ETV combined with ADV and LAM combined with ADV were the independent risk factors for predicting eGFR decrease. Conclusion The treatment of LDT combined with ADV might improve the eGFR and protect the renal function. LDT may be a rescue therapy for patients with renal indeficiency.

Key words: Hepatitis B, Telbivudine, Adefovir dipivoxil, Glomerular filtration rate