Hydronephrosis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]


According to the society of Fetal Urology, hydronephrosis may be graded based on ultrasound findings into 4 types.


  • According to the society of Fetal Urology and alternative hydronephrosis grading system (AGS), hydronephrosis can be graded based on ultrasound findings into 4 types.[1][2][3][4][5][6]
Grade 0 No renal pelvis dilation Anteroposterior diameter of less than 4 mm in fetuses
Grade 1 Mild renal pelvis dilation Anteroposterior diameter less than 10 mm in fetuses
Grade 2 Moderate renal pelvis dilation Anteroposterior diameter between 10 and 15 mm in fetuses
Grade 3 Renal pelvis dilation along with all calyces dilatation
Grade 4 Renal pelvis dilation along with all calyces dilatation

with thinning of the renal parenchyma


  1. Belarmino JM, Kogan BA (January 2006). "Management of neonatal hydronephrosis". Early Hum. Dev. 82 (1): 9–14. doi:10.1016/j.earlhumdev.2005.11.004. PMID 16427220.
  2. Emamian SA, Nielsen MB, Pedersen JF, Ytte L (September 1993). "Sonographic evaluation of renal appearance in 665 adult volunteers. Correlation with age and obesity". Acta Radiol. 34 (5): 482–5. PMID 8369185.
  3. Kadioglu A (February 2010). "Renal measurements, including length, parenchymal thickness, and medullary pyramid thickness, in healthy children: what are the normative ultrasound values?". AJR Am J Roentgenol. 194 (2): 509–15. doi:10.2214/AJR.09.2986. PMID 20093617.
  4. Huntington DK, Hill SC, Hill MC (August 1991). "Sonographic manifestations of medical renal disease". Semin. Ultrasound CT MR. 12 (4): 290–307. PMID 1892691.
  5. Konda R, Sakai K, Ota S, Abe Y, Hatakeyama T, Orikasa S (May 2002). "Ultrasound grade of hydronephrosis and severity of renal cortical damage on 99m technetium dimercaptosuccinic acid renal scan in infants with unilateral hydronephrosis during followup and after pyeloplasty". J. Urol. 167 (5): 2159–63. PMID 11956470.
  6. Onen A (June 2007). "An alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis". J Pediatr Urol. 3 (3): 200–5. doi:10.1016/j.jpurol.2006.08.002. PMID 18947735.

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