Abstract: Adefovir dipivoxil (ADV) is widely used for anti-HBV treatment in China. But in recent years,
there are several reports of its adverse events. In addition, the follow-up of chronic hepatitis B patients who
were treated with ADV showed that the treatment has a risk of renal damage. It may be attributed to the
accumulation of human renal organic anion transporter 1 (HOAT-1), the restriction of multidrug resistance
protein 2 (MRP2) and mitochondria damaged in renal tubules cells. The common clinical manifestations
include abnormal serum creatinine concentrations, hypophosphatemia and secondary osteomalacia. In clinical
treatment, regular monitoring of serum phosphate, estimated glomerular filtration rate (eGFR) and serum
creatinine is necessary. In case of renal dysfunction, drug discontinuation, dosage reduction or supportive
treatment should be taken.