The incidence of kidney cancer is increasing worldwide, and more patients are being diagnosed with a renal mass.1 The widespread use of abdominal imaging has led to a rise in early detection of renal masses and tumor stage migration such that most patients diagnosed with kidney cancer have a renal mass of less than 4cm. As a result, an increasing number of older patients, including those with more advanced chronic kidney disease (CKD), are candidates for extirpative kidney surgery with either a radical or partial nephrectomy.