Background: kidney disease is becoming a global burden on public health. The use of HAARTrnworsens the progression of renal failure in HIV patients. Previous studies have incoherent TDFrnoutcomes on renal wellbeing. rnGeneral objective: To evaluate renal function among HIV positive adult patients takingrntenofovir compared with non-tenofovir containing highly active antiretroviral therapyrn(HAART) rnMethods: Institutional based cross-sectional comparative study was conducted using arnconvenience sampling method from May 20/ 2019 to December /20/ 2019 at ACSH, Mekelle,rnEthiopia. Socio-demographic and clinical characteristics of the study participants werernassessed using medical records, structured questionnaire, anthropometric measuring toolsrn(electronic weighing scale, adult height board), BDFACA Presto for CD4 determination,rnPentra machine for analyzing renal function was used and the obtained data was analyzedrnusing SPSS version 25.0. rnResult: During the enrolment to HAART, a total of( 9.1%,n=21) respondents had a loweredrnGFR level but after the intake of HAART for at least six months, the number of patients withrnlowered GFR level raised to 16.8%, n=39(9.5% for the TDF group and 7.3% for the non-TDFrngroup). Among the total 39(16.8%) declined GFR cases, thirty (12.9%) of study participantsrnhad mild renal dysfunction, 18(81.1%) vs. 12 (70.6%) for TDF and non-TDF groupsrnrespectively. But there was no statistically significant correlation between the severity of renalrndysfunction as described by GFR and the form of HAART regimen (P=0.31). After HAARTrninitiation, there was no significant mean difference in almost all of the test parameters for renalrnfunction. In those who received TDF-group, renal dysfunction is significantly predicted byrnolder age â‰¥50 years, being male, advanced immune-suppression (CD4