Sex	Female Male
Age	years
Presentation	Febrile UTI Non-febrile UTI Antenatal hydronephrosis Other
Laterality	Unilateral Bilateral
Volume as percent of predicted bladder capacity	%
Right reflux grade	None 1 2 3 4 or 5
When reflux started on right	None Filling Voiding
Left reflux grade	None 1 2 3 4 or 5
When reflux started on left	None Filling Voiding
Duplication	Yes No
Voiding Dysfunction	Present Absent
Relative Renal Function in refluxing kidney	%
Renal Scan	Abnormal (less than 40% or renal scar) Normal