What do the Grades of Reflux Mean?

We were beginning to understand what vesicoureteral reflux was, and why our daughter had been diagnosed, but what did it mean when they said that her reflux was grade V? We were told that grade V was the most severe grade, but I still didn't know exactly how that was determined, or what it meant.

The grades of reflux are determined as follows: (I got this info from Medscape )

Grade I - urine backs up into ureter only, and the renal pelvis (the renal pelvis is the area at the center of the kidney, urine collects here and is funneled into the ureter.) appears healthy, with sharp calyces (calyces are the collecting area for urine within kidney before it is passed through to the renal pelvis).

Grade II - urine backs up into the ureter, renal pelvis, and calyces. The renal pelvis appears healthy, with sharp calyces.

Grade III - urine backs up into the ureter and collecting system. The ureter and pelvis appear mildly dilated, and the calyces are mildly blunted.

Grade IV - urine backs up into the ureter and collecting system. The ureter and renal pelvis appear moderately dilated, and the calyces are moderately blunted.

Grade V - urine backs up into the ureter and collecting system. The pelvis severely dilates, the ureter appears tortuous, and calyces are severely blunted.

The good news is that reflux resolves spontaneously before adolescents in most cases of Primary VUR, depending on the grade. The resolution rates for grade III and under is found to be up to 80%. As the grade of reflux increases, the odds of resolution decrease. Grade 4 has a resolution rate of about 10%, and grade 5 has very little chance of resolving spontaneously.

For us that meant that Lizzie's reflux would probably not resolve over time, and would require surgery. We were told that our goal for surgery was around the age of 5.

Next... Symptoms of Vesicoureteral Reflux

 

Vesicoureteral Reflux, Symptoms of Reflux, Grades of Reflux, Testing for Reflux, Treatment for Reflux

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