Get the facts on the VUR grading scale

VUR Grading 1-5 defines the level of VUR your child has

What is the VUR grading scale?

Using X-rays of the urinary system, your doctor can tell you how serious your child’s VUR is with a grading scale. This scale ranges from grade 1 (mild) to grade 5 (severe). Milder grades of VUR can go away on their own. However, the more severe the VUR, the less likely it will go away on its own (called spontaneous resolution).1 The likelihood of spontaneous resolution varies according to a child’s age, grade of VUR, and whether the VUR is on one ureter or both. Knowing which grade of VUR your child has is important in determining with your paediatric urologist which treatment will work best.


Normally, urine is made in the kidneys and it only flows one way: down the ureters and into the bladder. VUR occurs when urine flows back up from the bladder through the ureters. This can happen on one or both sides.

Grade 1

Grade 1 is the mildest form of VUR. Urine enters the ureter but does not travel all the way up to the kidney. The ureters look normal in size.

Grade 2

In grade 2, urine travels all the way up the ureter and enters the part of the kidney where urine is collected before it drains to the ureter (renal pelvis). The ureters and renal pelvis appear normal in size.

Grade 3

Grade 3 is similar to grade 2 except the ureters and/or the renal pelvis appear abnormal in size or shape.

Grade 4

Grade 4 is similar to grade 3, except the ureter is grossly enlarged.

Grade 5

Grade 5 is the most severe form of VUR. Similar to grade 4, except the ureter is also twisted and curved. The renal pelvis is also enlarged, and its normal structural details are no longer detectable.

Deflux is indicated for the treatment of children with VUR.

  1. Elder JS, Peters CA, Arant BS, et al. AUA pediatric vesicoureteral reflux clinical guidelines panel: The management of primary vesicoureteral reflux in children. American Urological Association Education and Research, Inc. 1997.