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To assess the risk of chronic kidney disease (CKD) associated with tenofovir disoproxil fumarate (TDF) use by baseline DAD CKD risk score. Adult antiretroviral therapy (ART)-naïve people living with HIV (PLWH) initiating treatment, with estimated glomerular filtration rate (eGFR) ≥60mL/min/1.73m , were identified in the OPERA cohort. CKD was defined as two or more consecutive eGFR60mL/min/1.73m , 90days apart. Associations between TDF use, baseline DAD CKD risk and incident CKD were assessed with incidence rates (IRs; Poisson re