To borrow from the vernacular so beloved of sports aficionados, it tempting to speculate that Hippocrates must have believed that defense, not offense, won championships, given the eponymous injunction of Primum non nocere (first do no harm), and not Primum facere bonum (first do good). In this issue of AJKD, Khattak et al1 use decision analysis to examine a common management issue in latter-day patients with advanced chronic kidney disease (CKD): the potential use of percutaneous coronary intervention in those with symptomatic, but stable, angina.