Abstract： Objective To investigate the effect of tenofovir disoproxil fumarate on early renal damage in patients with chronic hepatitis B.Methods 50 healthy people older than 50 years old(control group)and 50 chronic hepatitis B patients older than 50 years old(study group)who were from were Nanchang Ninth Hospital between January 2021 and March 2021 were enrolled.The follow-up period was 96 weeks.The changes of liver function,HBV-DNA,serum creatinine,serum cystatin C,serum retinol-binding protein and urinary microprotein were detected before and during the follow-up.Results In the study group,after 48 weeks of antiviral treatment with tenofovir disoproxil fumarate,the HBV-DNA value was lower than the detection limit,and the recovery rate of serum alanine aminotransferase was 70%.At baseline(0 week),there were no significant differences in serum creatinine,serum cystatin C,serum retinol-binding protein,and urinary microprotein between the two groups(P＞0.05).In the study group,for intra-group comparisons,there was no significant difference in serum creatinine at 24,48,72,96 weeks compared with 0 week(P＞0.05);in the study group,serum cystatin C,urinary microprotein of 24 weeks and 48 weeks compared with 0 weeks,no statistical difference(P＞0.05),at 72 weeks and 96 weeks,the values of the serum cystatin C and urinary protein were higher than 0 week,the difference was statistically significant(P＜0.05);serum retinol-binding protein value of 24 weeks,48 weeks and 72 weeks compared with 0 weeks,no statistical difference(P＞0.05),at 96 weeks,the serum retinol-binding protein value was higher than 0 week,the difference was statistically significant(P＜0.05).In the control group,there were no significant differences in serum creatinine,serum cystatin C,serum retinol-binding protein,and urinary microprotein at 24,48,72,and 96 weeks compared with 0 week(P＞0.05).Conclusion This study shows that antiviral therapy with tenofovir disoproxil fumarate is effective,but there may be a risk of early renal function damage,which should be paid attention to in clinical practice.