Objective:To investigate the effect of hepatitis B virus(HBV)on the HBV associated glomerulone nephritis(HBV-GN)under different alanine aminetransferase(ALT)levels. Methods:A total of 646 HBV-GN patients in the First Hospital of Lanzhou University were analyzed retrospectively. All the selected patients have complete medical records and have undergone renal histopathology. Laboratory tests include:N-acetyl-β-D-glucosidase(NAG),β2 microglobulin(β2M),liver function parameters ALT,renal function parameters creatinine(Cr),blood urea nitrogen(BUN),glomerular filtration rate(GFR). The HBV loads were measured by quantitative PCR. The distribution of pathological types of 646 HBV-GN was investigated,and the effects of HBV loads on renal function of the HBV-GN and stage of chronic kidney disease under different ALT levels were analyzed. Results:HBV-GN is mainly diffuse membrane hypertrophic nephropathy,accounting for about 60.7%,followed by capillary hyperplastic glomerulonephritis,accounting for about 26.2%,the focal segment glomerulonephritis and mesenteric hyperplastic lesions are rare. In the ALT normal HBV-GN patients group,the effect of HBV on the renal function is minor,while in the ALT abnormal group,the effect is significant,and this difference is obvious in the ALT≥2ULN(upper limit of normal). With viral load increasing,blood Cr,BUN,24 h urine protein quantification,urine NAG,β2M increased,while GFR decreased(P < 0.05). In the normal ALT group and the ALT<2ULN group,the viral load has no relationship with chronic kidney disease staging,but in the ALT≥2ULN group the viral load had a significant relationship with the chronic kidney disease staging. Conclusion:In different ALT condition,the effect of HBV on HBV-GN is different. A comprehensive analysis of this phenomenon is conducive to the clinical diagnosis and treatment of this disease.