Grades of VUR
So we now knew that Lizzie had Grade 5 VUR, but what did that mean? We found out that VUR is divided into 5 grades, with 5 being the most severe.
This is how the grades are determined: (I got this info from Medline)
- Grade I – urine backs up into ureter only, and the renal pelvis appears healthy, with sharp calyces.
- 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 VUR resolves spontaneously before adolescents in most cases of Primary VUR, depending on the grade. The resolution rates for grade3 and under is up to 80%. As the grade increases, the odds 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 VUR would probably not resolve, and would require surgery around the age of 5.
