Kidney conditions: function, stones and the exam

How VA rates kidney conditions

38 CFR 4.115a, 4.115b

Kidney conditions are rated in 38 CFR 4.115a (the levels) and 4.115b (the diagnostic codes). Most kidney codes simply say “rate as renal dysfunction.” So one table decides most kidney ratings.

The renal dysfunction table is built on lab results, mainly the glomerular filtration rate (GFR). The Federal Register notice that revised the genitourinary schedule took effect November 14, 2021. It replaced subjective wording in the old criteria, such as “markedly,” “some” and “slight,” with objective lab measures, mainly GFR and the albumin/creatinine ratio.

The rule accepts GFR, estimated GFR (eGFR) and creatinine-based approximations of GFR when a medical professional determines they are appropriate and calculates them.

The levels for renal dysfunction

38 CFR 4.115a

• 100%: chronic kidney disease with a GFR under 15 for at least 3 consecutive months during the past 12 months; or regular routine dialysis; or an eligible kidney transplant recipient.
• 80%: GFR 15 to 29 for at least 3 consecutive months during the past 12 months.
• 60%: GFR 30 to 44 for at least 3 consecutive months during the past 12 months.
• 30%: GFR 45 to 59 for at least 3 consecutive months during the past 12 months.
• 0%: GFR 60 to 89 and one of these for at least 3 consecutive months during the past 12 months: recurrent red or white blood cell casts or granular casts; a structural kidney abnormality (cystic, obstructive or glomerular); or an albumin/creatinine ratio (ACR) of 30 mg/g or more.

GFR values are in mL/min/1.73 m². The time test matters at every level. The numbers must hold for at least 3 consecutive months inside the past 12 months.

Kidney diagnoses that are rated as renal dysfunction

38 CFR 4.115b, DC 7502 to 7544

• Chronic nephritis (7502), glomerulonephritis (7536), interstitial nephritis including gouty nephropathy (7537), papillary necrosis (7538), renal amyloid disease (7539).
• Chronic pyelonephritis (7504): renal dysfunction or urinary tract infection, whichever is predominant.
• Chronic renal disease requiring regular dialysis (7530).
• Cystic kidney diseases (7533): the note names polycystic disease, medullary sponge kidney, Alport’s syndrome and Fabry’s disease, among others.
• Atherosclerotic renal disease (7534): renal artery stenosis or atheroembolic disease.
• Toxic nephropathy (7535): from antibiotics, radiocontrast agents, nonsteroidal anti-inflammatory drugs (NSAIDs), heavy metals and similar agents.
• Renal involvement in diabetes, type I or II (7541).
• Kidney disease from a virus (7544): HIV, hepatitis B or hepatitis C.
• DIC with renal cortical necrosis (7540).

The note to 7539 says that code covers kidney involvement from systemic diseases, such as lupus, scleroderma, Goodpasture’s syndrome and sickle cell disease.

Diabetes, high blood pressure and the kidneys

38 CFR 4.115b, DC 7541, 7507

Diabetic kidney disease (7541) is rated as renal dysfunction, with the levels above. See diabetes, thyroid and adrenal ratings.

Arteriolar nephrosclerosis (7507) is rated by predominant symptoms as renal dysfunction, hypertension or heart disease. If it is rated under the cardiovascular schedule, the percentage that would otherwise be assigned is raised to the next higher evaluation. See hypertension ratings.

Kidney removal and kidney transplant

38 CFR 4.115b, DC 7500, 7531

• One kidney removed (7500): minimum 30%. Or it is rated as renal dysfunction if there is nephritis, infection or pathology of the other kidney.
• Kidney transplant (7531): 100% following transplant surgery, from the date of hospital admission, with a mandatory VA exam one year after hospital discharge. After that it is rated on residuals as renal dysfunction, with a minimum of 30%.

Losing one kidney to a service-connected disability can also matter for special monthly compensation. See the paired organs and extremities rule.

Kidney stones and blocked kidneys

38 CFR 4.115b, DC 7508, 7509, 7511

• Kidney or ureter stones, nephrocalcinosis (7508): rated as hydronephrosis, except that recurrent stone formation needing invasive or non-invasive procedures more than two times a year is 30%.
• Hydronephrosis (7509): severe is rated as renal dysfunction. Frequent colic attacks with infection and impaired kidney function 30%; frequent colic attacks requiring catheter drainage 20%; only an occasional attack, not infected and not requiring catheter drainage 10%.
• Ureter stricture (7511): rated as hydronephrosis, with the same 30% exception for recurrent stones needing diet or drug therapy, or procedures more than twice a year.

Kidney infection and tubular disorders

38 CFR 4.115a, 4.115b, DC 7501, 7532

• Kidney abscess (7501): rated as urinary tract infection.
• Renal tubular disorders (7532) (such as renal tubular acidosis, Fanconi’s and Bartter’s syndromes): minimum 20% for a symptomatic condition, or rate as renal dysfunction.
• Urinary tract infection levels (4.115a): 30% for recurrent symptomatic infection requiring drainage by stent or nephrostomy tube, more than 2 hospitalizations a year, or continuous intensive management; 10% for 1 to 2 hospitalizations a year or suppressive drug therapy lasting six months or longer; 0% for suppressive therapy under six months without hospitalization. With poor renal function, rate as renal dysfunction.

Kidney and other genitourinary cancer

38 CFR 4.115b, DC 7528, 7529

A malignant neoplasm of the genitourinary system (7528) is rated 100%. After surgery, radiation, chemotherapy or other treatment ends, the 100% continues with a mandatory VA exam six months later. If there is no local recurrence or metastasis, it is then rated on residuals as voiding dysfunction or renal dysfunction, whichever is predominant. Benign neoplasms (7529) are rated the same way, without the 100%.

Kidney cancer is on VA’s presumptive lists for some veterans. See presumptive conditions by era.

What VA’s kidney exam form covers

VA Kidney Conditions DBQ (updated 2025-04-28)

• Diagnosis from a checklist, history, cause and onset, and continuous medication.
• Dialysis: whether regular dialysis is required.
• Removal and transplant: whether a kidney was removed, whether you are eligible for a transplant, or have had one, with dates and hospital details.
• GFR results with dates, and urine tests: ACR of 30 mg/g or more, and red cell, white cell or granular casts over at least three consecutive months in the past year.
• Structural abnormalities: cystic, obstructive or glomerular, and the tests used.
• Kidney stones: whether you have had them, and recurrent-stone treatment, including procedures and how often per year.
• Infections: treatment, and hospitalizations per year.
• Hypertension or heart disease caused by a kidney condition. A yes answer requires a separate Hypertension and/or Heart Disease questionnaire.
• Functional impact on work, with examples.

See Preparing for Your C&P Exam.

How kidney ratings add up

38 CFR 4.115a, 4.14, 4.25

Where a code sends VA to a specific area of dysfunction, only the predominant area is rated. Distinct disabilities may be rated separately if their symptoms do not overlap (38 CFR 4.14). Separate ratings are combined, not added. See Why 50% + 50% Is Not 100%. If a kidney condition has worsened, see When To Ask VA For A Rating Increase. For loss of a kidney or kidney function, see special monthly compensation.

What I could not verify

• The rating levels come from the eCFR text of 38 CFR 4.115a and 4.115b (current as of October 16, 2026). eCFR is unofficial, and the official text wins over me.
• I checked the kidney exam form through a text reader of VA’s PDF, not line by line. The form itself is the authority.
• I did not check how VA treats a GFR that goes up and down over the year. The text says “at least 3 consecutive months during the past 12 months,” and I found no VA source that explains how that is applied in practice.
• I did not research medical links between other conditions or medicines and kidney disease. This page covers the rating criteria.
• Bladder, urine leakage, urinary frequency, prostate and reproductive conditions are rated in the same section, but are not covered here.