38 CFR Part 4 — 38 CFR § 4.115b

Pyelonephritis, chronic — VA Diagnostic Code 7504

Genitourinary

Diagnostic code

7504

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38 CFR § 4.115b lists Diagnostic Code 7504 as “Pyelonephritis, chronic:”. The title ends with a colon. The rating cell is empty. The next cell says: “Rate as renal dysfunction or urinary tract infection, whichever is predominant.” That cell ends with a period. The code does not print a percentage of its own. Appendix B to Part 4 indexes “Pyelonephritis, chronic.” with a period and without the colon.

Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was up to date as of 2026-10-01 and last amended on 2026-08-27. The § 4.115b source note prints 59 FR 2527, Jan. 18, 1994; 59 FR 14567, Mar. 29, 1994, as amended at 59 FR 46339, Sept. 8, 1994; 86 FR 54086, Sept. 30, 2021. The § 4.115a source note prints 59 FR 2527, Jan. 18, 1994; 59 FR 10676, Mar. 7, 1994; 86 FR 54085, Sept. 30, 2021.

The rating criteria at each level

7504 Pyelonephritis, chronic — the cell this code prints

Rating %: —

Criteria (verbatim). Rate as renal dysfunction or urinary tract infection, whichever is predominant.

Rating %	Criteria (verbatim)
—	Rate as renal dysfunction or urinary tract infection, whichever is predominant.

Renal dysfunction — § 4.115a, one area the DC 7504 cell names

Rating %: 100

Criteria (verbatim). Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient

Rating %: 80

Criteria (verbatim). Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months

Rating %: 60

Criteria (verbatim). Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months

Rating %: 30

Criteria (verbatim). Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months

Rating %: 0

Criteria (verbatim). GFR from 60 to 89 mL/min/1.73 m² and either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73 m² and structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73 m² and albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months

Rating %	Criteria (verbatim)
100	Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient
80	Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months
60	Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months
30	Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months
0	GFR from 60 to 89 mL/min/1.73 m² and either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73 m² and structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73 m² and albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months

Urinary tract infection — § 4.115a, the other area

Rating %: 30

Criteria (verbatim). Recurrent symptomatic infection requiring drainage by stent or nephrostomy tube; or requiring greater than 2 hospitalizations per year; or requiring continuous intensive management

Rating %: 10

Criteria (verbatim). Recurrent symptomatic infection requiring 1-2 hospitalizations per year or suppressive drug therapy lasting six months or longer

Rating %: 0

Criteria (verbatim). Recurrent symptomatic infection not requiring hospitalization, but requiring suppressive drug therapy for less than 6 months

Rating %	Criteria (verbatim)
30	Recurrent symptomatic infection requiring drainage by stent or nephrostomy tube; or requiring greater than 2 hospitalizations per year; or requiring continuous intensive management
10	Recurrent symptomatic infection requiring 1-2 hospitalizations per year or suppressive drug therapy lasting six months or longer
0	Recurrent symptomatic infection not requiring hospitalization, but requiring suppressive drug therapy for less than 6 months

Note: GFR, estimated GFR (eGFR), and creatinine-based approximations of GFR will be accepted for evaluation purposes under this section when determined to be appropriate and calculated by a medical professional.

The 0 percent renal line is three rows in § 4.115a. The 0 is printed on the albumin/creatinine row. The casts row and the structural-abnormalities row sit above it, and each of those two rows ends with “or”. The 2 in m² is a superscript.

Urinary tract infection also prints a row with no percentage: “Poor renal function: Rate as renal dysfunction.”

The DC 7504 cell does not print “voiding dysfunction.” DC 7512 does.

38 CFR § 4.115a says: “Where diagnostic codes refer the decision maker to these specific areas of dysfunction, only the predominant area of dysfunction shall be considered for rating purposes.” The same paragraph says distinct disabilities may be evaluated separately under that section, pursuant to § 4.14, if the symptoms do not overlap. The percentages above are the § 4.115a lines the DC 7504 cell names. They are not extra percentages printed under DC 7504 itself. 38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just.

DC 7502 is chronic nephritis and says only “Rate as renal dysfunction.” DC 7530 says only “Rate as renal dysfunction.” Neither adds “or urinary tract infection, whichever is predominant.” DC 7500 is removal of one kidney, with a minimum evaluation of 30, or a renal-dysfunction rating if there is nephritis, infection, or pathology of the other.

The opening note of § 4.115b says that when evaluating any claim involving loss or loss of use of one or more creative organs, refer to § 3.350 of this chapter. DC 7504 does not carry the superscript 1 that the footnote uses.

The 2026-10-01 text of 38 CFR § 3.309 does not contain “pyelonephritis.” Paragraph (f) lists “Kidney cancer.” for Camp Lejeune. The chronic-disease list includes “Calculi of the kidney, bladder, or gallbladder.” Those sentences do not assign DC 7504.

Source: 38 CFR § 4.115b, Diagnostic Code 7504, and 38 CFR § 4.115a, eCFR full-text XML for 2026-10-01.

What the words mean in your records

Whichever is predominant

That phrase is the whole rating cell. Section 4.115a says only the predominant area of dysfunction shall be considered for rating purposes when a diagnostic code refers to these areas.

Poor renal function

That sentence sits under Urinary tract infection and has no percentage of its own. It says to rate poor renal function as renal dysfunction.

Not the calculus sentence

Calculi of the kidney, bladder, or gallbladder is a chronic-disease name in § 3.309(a). It has no diagnostic code. DC 7504 does not use the word “calculi.”

Evidence that speaks to each level

The DC 7504 cell

What the rater needs to see. Whether renal dysfunction or urinary tract infection is the predominant area.

Where that usually lives. The decision and the findings it uses for that choice.

Renal dysfunction, when that is the area used

What the rater needs to see. The GFR range for at least 3 consecutive months during the past 12 months, regular routine dialysis, eligible transplant status, or the casts, structural abnormalities, or ACR the 0 percent line names.

Where that usually lives. Laboratory results calculated by a medical professional, as the renal note states.

Urinary tract infection, when that is the area used

What the rater needs to see. The hospitalization, drainage, or suppressive-therapy facts on the 30, 10, or 0 line.

Where that usually lives. Infection treatment notes. Poor renal function is the sentence that points back to renal dysfunction.

Level	What the rater needs to see	Where that usually lives
The DC 7504 cell	Whether renal dysfunction or urinary tract infection is the predominant area.	The decision and the findings it uses for that choice.
Renal dysfunction, when that is the area used	The GFR range for at least 3 consecutive months during the past 12 months, regular routine dialysis, eligible transplant status, or the casts, structural abnormalities, or ACR the 0 percent line names.	Laboratory results calculated by a medical professional, as the renal note states.
Urinary tract infection, when that is the area used	The hospitalization, drainage, or suppressive-therapy facts on the 30, 10, or 0 line.	Infection treatment notes. Poor renal function is the sentence that points back to renal dysfunction.

VA’s public DBQ list, checked October 5, 2026, names “Kidney Conditions” under Genitourinary. The file is Kidney Conditions.

The exam form

DC 7504 prints one sentence and no percentage of its own. This page does not say the form replaces that sentence.

Related codes and how they interact

Nephritis and chronic renal disease use a shorter sentence.

DC 7502 and DC 7530 say “Rate as renal dysfunction.” They do not add urinary tract infection. DC 7504 names both areas and says whichever is predominant.

Secondary conditions and presumptions

Section 3.309 does not contain “pyelonephritis,” and it does not assign DC 7504. Kidney cancer and calculi of the kidney stay different sentences.

A separate question, when a presumption does not decide it, is a medical question on the facts under 38 CFR § 3.310. Paragraph (a) covers disability proximately due to or the result of a service-connected disease or injury. Paragraph (b) covers increase in severity and requires a medical baseline.

Short answers

How does VA rate chronic pyelonephritis?

Under 38 CFR § 4.115b, Diagnostic Code 7504 rates the condition as renal dysfunction or urinary tract infection, whichever is predominant. Those percentages are in § 4.115a. Education only. VA decides on the evidence.

Is pyelonephritis the kidney-cancer presumptive?

Section 3.309(f) lists “Kidney cancer.” for Camp Lejeune. The 2026-10-01 text does not contain “pyelonephritis,” and it does not assign DC 7504.

FAQ

What percentage does DC 7504 print?

None. The cell says to rate chronic pyelonephritis as renal dysfunction or urinary tract infection, whichever is predominant. The percentages are in § 4.115a. Education only.

Where is the renal 0 percent printed?

On the albumin/creatinine row: GFR from 60 to 89 mL/min/1.73 m² and ACR ≥30 mg/g for at least 3 consecutive months during the past 12 months. The casts row and the structural-abnormalities row are the two rows above it. The 2 in m² is a superscript.

Does the cell include voiding dysfunction?

No. Voiding dysfunction is a different heading in § 4.115a. DC 7512 says “Rate as voiding dysfunction.” DC 7504 does not.

Next steps

Read the decision for DC 7504 and which § 4.115a area it called predominant.
The free worksheet is a place to write the code, the findings, and the records you already have. It does not file a claim or protect a filing date. An accredited representative is at find a VSO.
Other genitourinary codes are on the genitourinary diagnostic-code index. The category page is genitourinary conditions.

Education only. Not legal or medical advice. My Claim Packet is not a VA-accredited representative and does not file claims. VA decides every claim on its own evidence.

Other codes in this body system

Nearby catalog entries in Genitourinary, ordered by diagnostic code number. All Genitourinary codes

Also: DC code lookup (tools) lists the same index in a compact layout.

Source: 38 CFR Part 4, Diagnostic Code 7504 • va.gov

⚠️ Important Disclaimer

This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.