The Ultrasound Grading System of the Society for Fetal Urology (SFU)

The Society for Fetal Urology (SFU) has developed a grading system for hydronephrosis in a fetus or neonate.

Parameters seen on ultrasound:

(1) central renal echo complex and renal pelvis

(2) calices

(3) renal parenchyma

Appearance	Grade
central renal echo complex closely apposed (no hydronephrosis)	0
slight separation of the central renal echo complex	1
further dilatation of the renal pelvis one to a few renal calices can be seen	2
renal pelvis dilated multiple fluid filled calices throughout the kidney renal parenchyma shows normal thickness	3
renal pelvis dilated multiple fluid filled calices throughout the kidney renal parenchyma over the calices is thinned	4

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