Summary

Background and objectives Clinically, hepatitis B virus (HBV) infection is observed to be associated with nephropathy. However, previous population-based studies failed to show an association betweenHBV infection and CKD. Therefore, this cross-sectional study was designed to further explore this association. Design, setting, participants, & measurements A representative sample of 6854 Chinese adults aged 30–75 years was tested for levels of serum hepatitis B surface antigen, alanine aminotransferase (ALT), creatinine, urinary albumin/creatinine ratio, and potential CKD risk factors. Results Neither HBV infection nor elevated ALT (ALT+; $ sex-specific 90th percentile of ALT levels of non-infected persons) was significantly associated with reduced estimated GFR (eGFR, 60 ml/min per 1.73 m2). Comparedwith noninfected persons, HBV-infected personswith ALT+, but not thosewith ALT2 (P=0.26), were more likely to have reduced eGFR (odds ratio, 4.07; 95 % confidence interval, 1.18–14.0; P=0.03). Further analysis with a general linear model revealed a significant difference in eGFR (mean6 SEM) between HBV-infected and noninfected persons (87.860.8 versus 90.260.4ml/min per 1.73m2;P=0.002). This differencewasmainly derived from that between HBV-infected persons with ALT+ and noninfected persons, with an average difference in eGFR of24.5 (95 % confidence interval,20.9 to28.1; P=0.01). HBV infection and ALT+, alone or in combination, were not significantly associated with albuminuria or CKD. Conclusions HBV infection with elevated ALT, rather than HBV infection alone, was associated with reduced renal function