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Resolution and Renal Outcomes in Children with High-Grade Vesicoureteral Reflux: A Longitudinal Study Using

Nooshin Tafazoli1,2, Mitra Naseri2

  • 1Department of Urology, Stanford School of Medicine, California, Stanford, USA.

Nuclear Medicine and Molecular Imaging
|July 26, 2026
PubMed

Insights

High-grade vesicoureteral reflux (VUR) in children rarely resolves spontaneously. New renal scarring is common, suggesting a need to re-evaluate early surgical intervention guidelines for pediatric VUR.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Medical Research

Background:

  • High-grade vesicoureteral reflux (VUR) in children has a low chance of resolving on its own.
  • Renal scarring is a significant concern in pediatric VUR cases.

Purpose of the Study:

  • To evaluate the resolution rate of high-grade VUR over one to three years.
  • To assess the incidence of new renal scarring in children with high-grade VUR.

Main Methods:

  • A longitudinal study was conducted on children under 18 with high-grade VUR.
  • Data from March 2003 to 2022 were analyzed, with missing data handled via multiple imputation.

Main Results:

  • Complete VUR resolution was 11.80% with medical prophylaxis and 28.10% with surgery.
  • New renal scars developed in 46.50% of patients.
  • Spontaneous VUR resolution was higher in grade V than grade IV; new scarring was more common with antenatal hydronephrosis (ANH).

Conclusions:

  • The spontaneous resolution rate for high-grade VUR is low within three years.
  • New renal scars frequently develop during follow-up.
  • Findings suggest reconsidering criteria for early surgical intervention in pediatric VUR.
Abstract

Keywords:
ChildHigh-grade VURRenal scarringResolution of VUR

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