Editing Pediatrics: Vesicoureteral Reflux (section)

== Natural History ==

* '''<span style="color:#ff0000">At birth, the probability of spontaneous resolution of primary VUR is inversely proportional to the initial grade'''
** '''<span style="color:#ff0000">Most cases of low-grade reflux (grade 1 and 2) will resolve'''
** '''<span style="color:#ff0000">Grade 3 reflux will resolve in ≈50% of cases'''
** '''<span style="color:#ff0000">Very few cases of higher-grade reflux (grades 4 and 5, and bilateral grade 3) will resolve spontaneously'''
*** Attempting to discriminate true differences in resolution rates for grades 3 and higher reflux may not be particularly clinically relevant.
* '''At a later age, spontaneous resolution will depend on:'''
*# '''Initial grade of reflux, if it is known'''
*# '''Age at presentation (more important)'''
** '''Resolution by Age'''
*** The age at which reflux begins or is first encountered will play a more potent role in the management of the patient with reflux than the grade itself
*** '''When reflux resolves, it often does so within the first few years of life'''
*** '''The traditional period of observation for resolution is 5 years'''