Objective To investigate the changes in the renal function of the patients with chronic hepatitis B (CHB) receiving Telbivudine (L-DT) or Adefovir (ADV) monotherapy, and determine whether L-DT has the effect of increasing the estimated glomerular filtration rate (eGFR). Methods A retrospective analysis was made for 118 CHB patients receiving either L-DT (n = 67) or ADV (n = 51) monotherapy for 52 weeks. The dynamic changes of eGFR on baseline, in the 24th and 52nd weeks of treatment were analyzed. The proportions of the patients with impaired renal function (eGFR <90 ml/min.1.73 m2) were compared between both groups. Results Compared to the baseline levels, CR decreased and eGFR increased significantly in the L-DT group after 52 weeks of treatment (P < 0.05), while CR increased and eGFR decreased significantly in the ADV group (P < 0.05). No patient was found to have CR higher than the upper limit of normal level (ULN) or an elevation of CR over 0.50 mg/dl before and after treatment. In the L-DT group the proportion of the patients with impaired renal function (based on eGFR) decreased from 20.90% at baseline to 5.97% at the 52th week, while that in the ADV group increased from 19.61% to 23.53%. The proportion of the patients with impaired renal function had no statistical difference at baseline (P > 0.05), but had statistical difference at week 52 (P < 0.05) between the two groups. Conclusions L-DT antiviral therapy can increase eGFR and improve the renal function. However, when using ADV therapy, the decrease of serum eGFR should be paid attention in early stage, and the therapy should be adjusted timely.