Platinum Priority – Editorial Referring to the article published on pp. 996–1003 of this issue Understanding Chronic Kidney Disease of Surgical Versus Medical Origin: The Missing Link to the Partial Versus Radical

In the USA and Europe, nephron-sparing surgery (NSS) has become accepted as the gold standard for renal masses of 4 cm in size [1,2]. There is general consensus in the urologic community that the acceptable increase in perioperative surgical risk inherent to partial nephrectomy (PN) is justified by the theoretical benefit of avoiding the long-term deleterious renal functional consequences asso-ciated with radical nephrectomy (RN). Concerns regarding adverse events associated with a decline in glomerular filtration rate (GFR) [3], such as cardiovascular compromise, chronic anemia, bone demineralization, and metabolic disturbances, have resulted in the intuitive and widely embraced hypothesis that NSS may result in a survival advantage when comparing PN and RN. Enthusiasm for NSS was fueled by observational studies demonstrating larg