| A urologist should lead the counseling process and should consider all management strategies. A multidisciplinary team should be included when necessary. |
| Counseling should include current perspectives about tumor biology and a patient-specific oncologic risk assessment. For cT1a tumors, the low oncologic risk of many small renal masses should be reviewed. |
| Counseling should review the most common and serious urologic and non-urologic morbidities of each treatment pathway and the importance of patient age, comorbidities/frailty, and life expectancy. |
| Physicians* should review the importance of kidney functional recovery related to kidney mass management, including risk of progressive CKD, potential short/long-term need for dialysis, and long-term overall survival considerations. |
| Consider referral to nephrology in patients with a high risk of CKD progression, including those with GFR <45 mL/minute/1.73 m2, confirmed proteinuria, diabetics with preexisting CKD, or whenever GFR is expected to be <30 mL/minute/1.73 m2 after intervention. |
| Recommend genetic counseling for all patients ≤46 years of age and consider genetic counseling for patients with multifocal or bilateral kidney masses or if personal/family history suggests a familial kidney neoplastic syndrome. |
