VUR Grading

Grade I

Reflux into the ureter only. No dilation of the ureter. Normal pelvicaliceal system.

Grade II

Reflux into the ureter, pelvis, and calyces. No dilation of the collecting system. Normal fornices.

Grade III

Mild-to-moderate dilation of the ureter, renal pelvis, and calyces. Blunting of the fornices. Ureteral tortuosity absent or minimal.

Grade IV

Moderate dilation and/or tortuosity of the ureter. Moderate dilation of the pelvis and calyces. Obliteration of sharp angle of fornices but papillary impressions maintained in most calyces.

Grade V

Gross dilation and tortuosity of the ureter. Gross dilation of the renal pelvis and calyces. Papillary impressions no longer visible in most calyces.