The Society of Fetal Ultrasound has developed a grading system for hydronephrosis, initially intended for use in neonatal and infant hydronephrosis, but it is now used for grading hydronephrosis in adults as well:<ref>{{cite web|url=https://www.uptodate.com/contents/overview-of-fetal-hydronephrosis|title=Overview of fetal hydronephrosis. Version Version 29.0|authorPlanning=Laurence S Baskin|website=[[UpToDate]]|accessdate=2017-04-25}} Last updated Apr 20, 2017</ref>* Grade 0 – No renal pelvis dilation. This means an anteroposterior diameter of less than 4 mm in [[fetus]]es up to 32 weeks of [[gestational age]] and 7 mm afterwards.<ref name="D'Addario2014">[https://books.google.com/books?id=2PwlBgAAQBAJ&pg=PA189 Page 189] in: {{cite book|title=Donald School Basic Textbook of Ultrasound in Obstetrics & Gynecology|author=V. D'Addario|publisher=JP Medical Ltd|year=2014|isbn=9789351523376}}</ref> In adults, [[cutoff (reference value)|cutoff values]] for renal pelvic dilation have been defined differently by different sources, with anteroposterior diameters ranging between 10 and 20 mm.<ref>[https://books.google.com/books?id=7YfQAQAAQBAJ&pg=PA78 Page 78] in: {{cite book|title=Emergency Ultrasound Made Easy, Edition 2|author=Justin Bowra, Russell E|publisher=Elsevier Health Sciences|year=2011|isbn=9780702048722}}</ref> About 13% Hydronephrosis - choice of normal healthy adults have a transverse pelvic diameter of over 10 mm.<ref>{{cite journal |vauthors=Emamian SA, Nielsen MB, Pedersen JF, Ytte L |title=Sonographic evaluation of renal appearance in 665 adult volunteers. Correlation with age and obesity |journal=Acta Radiol |volume=34 |issue=5 |pages=482–5 |year=1993 |pmid=8369185 |doi= 10.3109/02841859309175388|url=modality}}</ref>* Grade 1 (mild) – Mild renal pelvis dilation (anteroposterior diameter less than 10 mm in fetuses<ref name="D'Addario2014" />) without dilation of the calyces nor parenchymal atrophy* Grade 2 (mild) – Moderate renal pelvis dilation (between 10 and 15 mm in fetuses<ref name="D'Addario2014" />), including a few calyces * Grade 3 (moderate) – Renal pelvis dilation with all calyces uniformly dilated. Normal renal parenchyma* Grade 4 (severe) – As grade 3 but with thinning of the renal parenchyma