Abstract: Objective:To investigate the effect of tenofovir alafenamide fumarate (TAF), entecavir (ETV) or tenofovir disoproxil fumarate(TDF)on glomerular filtration rate in patients with chronic hepatitis B(CHB).Methods:A total of 230 CHB patients initially treated in the First Affiliated Hospital of Guangxi Medical University from March 2019 to August 2022 were divided into TAF group(74 cases), TDF group(81 cases)and ETV group(75 cases), and were treated with TAF, TDF and ETV alone, respectively.The serum creatinine (sCr) concentrations were measured before treatment (baseline), and at 4 weeks, 12 weeks, 24 weeks, 36 weeks, and 48 weeks during treatment.The estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease (MDRD).The eGFR changes were compared between the three groups at baseline and 48 weeks after treatment, and repeated measurement analysis of variance was adopted to evaluate the change trends in the difference value(D-value)between eGFR and baseline at each time point in the groups.Results:There was no significant difference in eGFR between the TAF group and the ETV group after 48 weeks of treatment compared with baseline (all P> 0.05), but eGFR in the TDF group after 48 weeks of treatment was significantly lower than the baseline (P< 0.05).There was interaction in the D-value between eGFR and baseline between groups and time points in the 3 groups after treatment(P< 0.05).In the TAF group and ETV group, the D-value at almost each time point was basically positive, the maximum of two groups were both at the 36-week point and the overall change trends of the two groups were stable(P> 0.05).In the TDF group, the D-value at each time point was negative, the D-value of TDF group was the lowest at the 24-week point and the overall change trends were descending(P< 0.05).Conclusion:ETV and TAF have little effect on renal function in CHB patients and show better renal safety.With the prolongation of TDF treatment duration, renal function impairment becomes evident.TDF should be used with caution or avoided in patients who are elderly and have impaired renal function.