While serum creatinine was elevated by 0.3% in the remaining 12 (24%) patients taking tenofovir, none of them had hypouricemia, anemia, or an abnormal urine albumin-to-creatinine ratio, indicating that serum creatinine may be the first parameter to become abnormal in renal affection and necessitates intervention to avoid the progression of nephrotoxicity. Here, ALB is linked to anemia (phenotype).