Renal units with renal scarring by vesicoureteral reflux (VUR) grade.

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Renal units with renal scarring by vesicoureteral reflux (VUR) grade. Renal units with renal scarring by vesicoureteral reflux (VUR) grade. (A) (Any scarring): The percentage of renal units with any scarring was highest in grade 4 VUR; four of 311 (1%), six of 109 (6%), 11 of 400 (3%), 25 of 321 (8%), and 17 of 56 (30%) for grades 0, 1, 2, 3, and 4 VUR, respectively (P<0.001 for grade 4 versus all other grades). (B) (New scarring): The percentage of renal units with new scarring was highest in grade 4 VUR; three of 311 (1%), five of 109 (5%), nine of 400 (2%), 14 of 321 (4%), and 12 of 56 (21%) for grades 0, 1, 2, 3, and 4 VUR, respectively (P<0.001 for grade 4 versus all other grades). (C) (Segment increase in new scarring): Grade 1 (one or two segments) scarring was the most common segment increase in new scarring in 29 of 43 (67%) renal units, occurring in two, five, seven, eight, and seven renal units with grades 0, 1, 2, 3, and 4 VUR, respectively. A one-segment increase in new renal scarring was present in 33% of children, 35% had a two-segment increase, 21% had a three to four-segment increase, and 12% had a five-segment or greater increase. (D) (Severity grade of any scarring): Among 63 renal units with any scarring, grade B (mild) renal scarring was seen in more patients than grades C, D, and E (5%, 8%, 11%, 13%, and 11%, respectively, for grades 0, 1, 2, 3, and 4 VUR). Tej K. Mattoo et al. CJASN 2016;11:54-61 ©2016 by American Society of Nephrology