To analyze nerve conduction studies (NCS) performed in renal and urological patients and identify the common electrophysiologic patterns observed in this population.

Patients with renal or urological diseases frequently present with neuropathic symptoms similar to those in the general population. However, the underlying mechanisms and prevalence patterns may differ because of metabolic, vascular, or treatment-related factors. This study aimed to identify distinctive patterns of neuropathy on NCS, conducted at a free tertiary-care center in a low-income country that provides comprehensive care to renal and urological patients.

A retrospective review of NCS (Aug 2018–Aug 2025) in renal and urology referrals was analyzed using SPSS v22 after ethical approval. Both adult and pediatric patients referred from renal and urology departments were included. Patients without renal, urological, or oncologic conditions were excluded. Institutional Review Board approval and patient consent were obtained.

Of 1,200 NCS performed, 552 met inclusion criteria. The mean age was 39.9 ± 15.8 years, with 61.8 % males. Referrals were primarily from Nephrology (208) and Transplant (176) units, followed by Urology (56) and Vascular (43). Underlying conditions included ESRD on hemodialysis (217), renal transplant (178), and acute kidney injury (34). The most frequent abnormalities were sensory-motor axonal polyneuropathy (35.3 %) and mixed axonal-demyelinating polyneuropathy (10.5 %); 22.2 % had normal studies. Immune-mediated variants were less common (AMSAN 2.2 %, AMAN 0.5 %). Monomelic ischemic neuropathy (MIN) related to dialysis access occurred in 3.6 % of cases, with peroneal nerve involvement predominant (59.8 %). Arteriovenous fistula formation and its complications were associated with MIN.

Axonal neuropathy is the predominant pattern in patients with renal and urological disease. Arteriovenous fistula formation and its complications were associated with monomelic ischemic neuropathy. Early identification and timely neurophysiologic assessment are essential to prevent functional decline and disability in this high-risk group.