Graphical representation of the interactions among patient age, pre-operative kidney function, and the year of surgery. A) The odds ratio of receipt of partial nephrectomy by increasing age (per 5 year increase) shows a steady decline. B) The probability a reference patient would receive of partial nephrectomy by age group and year is shown with the oldest patients having the slowest rise. Reference patients were defined as white, male, with T1 tumors with continuous variables set at their average value (serum creatinine = 1.15 mg/dL, Charlson score = 1.92). C) Similarly, patients with impaired kidney function initially had increased odds of receipt of partial nephrectomy that decreased over the study period. D) The probability of reference patient receiving partial nephrectomy by quintile of pre-operative kidney function and year initially showed higher probabilities for patients with the lowest baseline function that reversed over the study period. Reference patients were defined as white, male, with T1 tumors with continuous variables set at their average value (age = 64.3 years, Charlson score = 1.92).