Our study had some limitations; the small sample size (as a result we were unable to assess factors associated with renal dysfunction), missing information for some patients (e.g. CD4 and Viral load) which were not done/documented by primary health care giver and no baseline renal function to assess change over time (routine testing of renal function tests was no longer being done by the primary health care giver (findings from the DART trial) and we had limited time for the study to check the baseline levels). Here, CD4 is linked to Abnormal renal physiology.