Abstract: Objective To explore the impact of combination telbivudine（LDT） and adefovir dipivoxil （ADV） on renal functions in the treatment of patients with chronic hepatitis B. Methods 178 patients with CHB were recruited in our hospital between April 2014 and July 2016,and our patients with CHB included 59 patients with LDT resistant,59 with ADV resistant,and 60 naive. All patients received LDT and ADV combination therapy,and were followed-up for 48 weeks. The changes of serum creatinine（Cr） levels and estimated glomerular filtration rate（eGFR） were compared among the three groups. Results At the end of 48 weeks,the complete response rate in naive patients was 46.7%,significantly higher thant 28.8% in LDT resistant group or 27.1% in ADV resistant group（P<0.05）;before treatment,serum Cr levels and eGFR in the three groups were not significantly different （P>0.05）,while at the end of 48 weeks,serum Cr level in naive patients was （63.2±12.3）μmol/L,much lower than （71.2±14.3） μmol/L in LDT resistant or （73.2±14.8） μmol/L in ADV resistant group （P<0.05）,and the eGFR was （111.4±16.1） ml·min^-1·1.73m²,significantly higher than （99.7±13.4） ml·min^-1·1.73m² in LDT resistant or（99.3±13.1） ml·min-1·1.73m² in ADV resistant group（P<0.05）. Conclusion Application of LDT and ADV combination is effective in the treatment of patients with chronic hepatitis B with resistant hepatitis B viral mutation infection,and the de novo combination of the two nucleosides might be in clinical trial for decreasing HBV mutation.

Key words: Hepatitis B, Telbivudine, Adefovir dipivoxil, Estimated glomerular filtration rate, Therapy