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VUR Grade 3

Understanding VUR grade 3 and its treatment options

What is VUR grade 3?

VUR grade 3 is similar to grade 2 where 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). However, in grade 3 the ureters and renal pelvis appear abnormal in size or shape.

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. 

VUR Resolution Chart – Percent Chance of Reflux Resolution After A Specified Number of Years1
American Urological Association

  Age 1 Year 2 Years 3 Years 4 Years 5 Years
Grade 3 – One Ureter

 0-24 months old 21.4% 38.2% 51.5% 61.9% 70%
Grade 3 – One Ureter

 2-5 years old 13.4% 25.0% 35.1% 43.8% 51.3%
Grade 3 – One Ureter

 5-10 years old 10.8% 20.5% 29.1% 36.7% 43.6%
Grade 3 – Both Ureters

 0-24 months old 12.7% 23.8% 33.5% 41.9% 49.3%
Grade 3 – Both Ureters

 2-5 years old
 7.0% 13.5% 19.6% 25.2% 30.5%
Grade 3 – Both Ureters

 5-10 years old 2.6% 5.2% 7.7% 10.1% 12.5%


More severe grades of reflux are associated with lower rates of spontaneous resolution and a higher incidence of renal scarring.2

VUR Grade 3 treatment options

There are basically four ways your child’s pediatric urologist or doctor may decide to treat your child, depending on the severity of your child’s VUR. The higher the grade, the more likely that treatment is needed. VUR treatment options are dependent on the grade but vary from watchful waiting, antibiotics, endoscopic treatment with Deflux, or surgery.3

Deflux is indicated for the treatment of children with VUR grades 2-4.

References

  • 1. Elder JS, Peters CA, Arant BS Jr, et al. Pediatric vesicoureteral reflux guidelines panel summary report on the management of primary vesicoureteral reflux in children. J Urol. 1997;157(5):1846-1851.

  • 2. Baskin LS, Kogan BA, Stock JA. Handbook of Pediatric Urology Third Edition. Philadelphia, PA: Wolters Kluwer; 2019.

  • 3. Peters CA, Skoog SJ, Arant BS Jr, et al. Summary of the AUA guideline on management of primary vesicoureteral reflux in children. J Urol. 2010;184(3):1134-1144.

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