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What Do Your Nails Look Like With Kidney Disease?

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Physiological changes occur when you have kidney problems, such as changes in urination patterns, metabolism, blood circulation, and sleep quality. However, many people fail to take notice of changes in their physical appearance (texture, color, shape), particularly their fingernails and toenails.  

Your nails can develop concave or spoon-shaped dents if you have kidney disease. Additionally, they may have a yellow overcoat or an unnatural white and red-brown coloration that divides the nail in half. Plus, they can also become brittle or get detached from the skin.   

The way your nails change may indicate the severity of kidney disease. For example, fingernails separating from the skin can signify chronic renal failure. Read the following lines to find out more about nails and kidney disease. 

Kidney Disease Nails Symptoms: How Do They Look Like? 

Your nails may not look as pretty as when you don’t have kidney disease. The impaired function of this organ leads to unusual coloration and keratin degradation that could increase your risk for infection. In addition, severe changes in the nails due to kidney disease occurs when the condition is at a later stage. 

Here are changes to watch out for when you have kidney disease. 

White Streaks

You may notice a white streak or pale band forming across your nail plate horizontally. It is also referred to as Muehrcke’s nails or line, named after Robert C. Muehrcke, the physician who described the condition. 

Muehrcke’s nails occur when blood flow is limited in the nailbed. A single line may not be necessarily alarming, but if you spot multiple streaks, consult with your doctor immediately. These lines could imply hypoalbuminemia (low blood albumin), a common end-stage renal disease symptom. To confirm the condition, take an albumin blood test

Concave Nails

A concave nail (spoon nail) that appears scooped out is due to the nails’ softening. The condition is clinically known as koilonychia. The abnormal curvature is often due to iron deficiency which can be common among those with kidney disease. 

Other conditions that cause koilonychia include hemochromatosis (iron overload), iron deficiency anemia, diabetes, hypothyroidism, psoriasis, and lupus.   

Did You Know? Iron deficiency anemia is common among women and can be easily overlooked. Learn about how serious iron deficiency anemia can get to take proper action to restore your health. 

Beau’s Lines

When you see a deep dent or depression formed horizontally on your fingernails or toenails, this is referred to as Beau’s lines – named after the physician who described it, Joseph Beau. 

Beau’s line can be linked to any temporary interruption in nail growth, particularly during cell division. Nails tend to grow out straight. But if something disturbs the smooth process, it could sustain a linear groove amidst the plat. People with acute kidney disease often develop Beau’s lines.  

Lindsay’s Nails

Also called half-and-half nails, Lindsay’s nails have the bottom half of the nail plate colored white, and the upper half either has a red or brown color. This condition may occur due to uremia (serum toxin buildup) or acidosis due to impaired glomerular filtration. 

About 20% to 50% of those with kidney disease have Lindsay’s nails. It’s also more common on toenails than on fingernails. The discoloration may not change for people undergoing dialysis, but it could disappear among those who have gone through a kidney transplant. 

Yellow coloring

It’s hard not to notice nails that start to turn yellow. The discoloration cab localized on one area of your nail plate, but it could also coat the entire surface. This yellow coloring can be linked to nitrogen waste accumulation in the blood, which could indicate chronic kidney disease (CKD)

An excellent way to monitor toxic waste buildup is to get screened for these common byproducts regularly. Your healthcare provider may recommend getting the blood urea nitrogen (BUN) test and creatinine blood test

Detached Nails 

If your nails start to separate from the skin, it could signal chronic renal failure. This condition is called onycholysis. The detachment of the nail plate from the nail bed can be partial or complete. Either way, it exposes a vulnerable part of your fingers and toes to infection that further aggravates onycholysis. 

Brittle Nails

With kidney disease, your nails may start to lose quality and integrity. It could become brittle and ridged or easily broken with light injuries. Additionally, having brittle nails may imply that you’re low in keratin. Consult your doctor immediately so your renal diet can be adjusted, if possible. 

Why Do Nails Change With Kidney Disease?

If you’ve been diagnosed with kidney disease or other conditions affecting your kidneys and blood circulation, naturally, your body will have difficulties eliminating waste products like BUN and creatinine. Without a functioning filtering system to remove them, these substances can build up in the bloodstream causing prominent changes in the body. 

In the case of patients with kidney disease, fingernails and toenails will start to change form, texture, and coloration as nitrogen becomes excessive. 

Additionally, recommended renal diets for kidney disease also limit certain nutrient quantities to prevent overloading the already-limited filtration function of the kidneys. As a result, you may suffer from nutrient deficiencies that affect keratin production. Keratin is a protein responsible for strengthening the nails and preventing hair loss.

When To See A Doctor

While kidney disease and nails may seem to have a direct connection, taking note of the changes in your fingernails and toenails will not be enough to assess the severity of the medical condition.

Still, a high degree of shifts and alterations in your nails could warrant a visit to your doctor. 

If your nail looks far off from what is normal and you exhibit other symptoms of chronic kidney disease like shortness of breath, irregular urination, blood in urine, insomnia, and muscle cramps, schedule an appointment with your physician immediately. 

Frequently Asked Questions 

How do I check if my kidneys are OK?

The surest way to check your kidney’s health is through kidney function tests. Your doctor may order lab work as simple as a urinalysis or multiple blood tests such as those in a comprehensive metabolic panel (CMP14). It will depend on your symptoms, family history, and risk for developing specific kidney disorders. 

Does kidney health also affect hair?

Chronic kidney disease can lead to hair loss—the severe impairment in the kidneys’ glomerular filtration results in vitamin, mineral, and protein deficiencies. Keep in mind that these nutrients are essential to keep your hair and nails healthy. As with nails, hair needs keratin which becomes limited with CKD. 

If you’re diagnosed with kidney disease, consider taking blood tests for vitamin or nutrient deficiencies. This way, your healthcare provider can calculate your risk for alopecia (hair loss) and get the right blood test. 

What other diseases show up in your nails?

Aside from kidney disease, changes in your nails can reveal other medical problems, such as heart disease, lung issues, inflammatory bowel disease (IBD), Reiter’s syndrome, liver disease, psoriasis, diabetes, and thyroid disease. 

When discussing chronic kidney disease symptoms with your doctor, mention changes in your nails – whether in shape or color. This could contribute to a speedy, accurate treatment. 

Bottom Line: 

Although kidney disease primarily affects your physiology, it doesn’t take long before your outward appearance catches up and starts to decline. For some, the so-called “renal failure nails” are apparent symptoms of kidney disease or even kidney failure, but for others, they may appear as unimportant alterations. 

But understanding their role in monitoring your kidneys’ health allows you to take the necessary medical actions the moment they contain the above mentioned changes. That way, you can take the right kidney function test and seek the proper clinical response. 

Medically Approved By Dr. Edward Salko, MD

Dr. Edward Salko is the board-certified physician who reviews lab tests provided by PERSONALABS™. He earned his Bachelor of Science in chemistry and pre-med from the University of Florida in Gainesville and his Doctor of Osteopathy Medicine in 1980 from Kansas City University School of Medicine.

Dr. Salko’s career has specialized in family and emergency medicine. His passion is to provide clients with the tools they need in the most convenient way possible to allow them to take charge of their own healthcare. He has held a variety of positions in Kansas, Florida and Washington. Currently, in addition to his duties as Medical Director for Personalabs, he is a practicing emergency physician in Kennewick, Washington.

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