How kidney disease affects your nails
When most people think about kidney disease, they consider the physiological changes that occur, from the quality of sleep and problems with blood circulation to changes in metabolism and urination patterns. However, changes in physical appearance are also common.
One of the most common physical effects noticed by those who suffer from kidney disease is in their toenails and fingernails, particularly affecting shape, color, and texture.
For people diagnosed with kidney disease, their nails may develop concave dents, a yellowish overcoat, or abnormal brown and white coloration dividing the nail. Their nails may also get brittle or become detached. In fact, how a person's nails change can indicate the disease's severity.
Read on for more information about how kidney disease affects the nails.
What do your nails look like with kidney disease?
Kidney disease can have a significant effect on the way your nails look. As kidney function is impaired, unusual coloration occurs, and patients may experience keratin degradation, increasing infection risk. Changes in texture, shape, and color continue as the disease progresses.
Here are some changes to be mindful of:
Yellow coloring
Whether localized to one section of the nail plate or coating the entire plate surface, it is difficult to miss this common discoloration, which may be linked to the accumulation of nitrogen waste in the bloodstream, an indicator of chronic kidney disease.
You can monitor the buildup of toxic waste in your body and your overall health by getting screened regularly through a creatinine blood test or a blood urea nitrogen (BUN) test.
White streaking
People diagnosed with chronic kidney disease may notice white streaking or pale horizontal bands forming along the nail. This condition is known as Muehrcke's nail or Muehrcke's line, referring to Robert Muehrcke, a physician who first described this condition. The condition occurs as blood flow in the bed of the nail becomes limited.
While a single pale line should not cause alarm, you should consult a doctor immediately if you notice multiple streaks. Such streaks can indicate a condition known as hypoalbuminemia, which is common among those with end-stage kidney diseases, sometimes called kidney failure nails.
Muehrcke's nail can be confirmed through blood tests.
Lindsay's nails
Sometimes referred to as half-and-half nails, this condition results in the nail plate's bottom half being pale white and a red-brown color appearing on the nail's upper half.
Among those with chronic kidney disease, Lindsay's nails appear in roughly 20% - 50% of patients. The condition, which results from acidosis or toxic buildups due to impaired glomerular filtration, commonly affects the toenails more than the fingernails.
The condition has been known to reverse itself following a successful kidney transplant. However, those undergoing dialysis usually don't see any change once the condition exists.
Concave nails
Concave nails, also known as spoon nails or iron deficiency kidney disease nails, get their name from the "scooped out" appearance of the nail as a result of softening. This irregular curvature is clinically referred to as koilonychia and usually results from iron deficiency experienced in kidney disease.
Koilonychia is not only a condition associated with chronic kidney disease. Those with lupus, psoriasis, hyperthyroidism, diabetes, iron deficiency anemia, and hemochromatosis, also known as iron overload, can experience koilonychia.
Beau's lines
Beau's lines is a condition where deep horizontal depressions or dents on fingernails and toenails occur due to temporary cellular growth interruptions. It was named after Dr. Joseph Beau, who first described the condition.
Although fingernails and toenails tend to grow smooth and straight, any disturbance in the growth process can cause linear grooves in the nail. Patients with chronic kidney disease commonly experience the condition.
Detached nails
The separation of the nails from your skin is a common symptom of chronic kidney disease. The condition, known as onycholysis, can also be caused by nail damage from an injury or a fungal infection.
Sometimes, the separation of the nails from the skin is partial, and other times, it is complete. In both situations, it exposes the patient to infections and further aggravation.
Brittle nails
For those who suffer from chronic kidney disease, their nails may lose integrity and quality, causing them to become brittle, ridged, and easily damaged.
Brittle nails are often a sign of low keratin.
If you suffer from chronic kidney disease and are experiencing brittle nails, contact your nephrologist or dietitian to adjust your diet.
Why nails change from kidney disease
The kidneys act as a filtration system, ridding our body of waste and delivering essential nutrients into our bloodstream. Unfortunately, as kidney disease progresses and function decreases, toxic substances will build up in our bloodstream and cause our nails to change color, form, and texture. High levels of nitrogen in the bloodstream often cause these physical changes.
Sometimes, chronic kidney disease sufferers will be placed on diets meant to slow the progression of the disease by limiting specific nutrient quantities to prevent a system overload on the already taxed kidneys. Unfortunately, that can result in nutrient deficiencies affecting keratin production, a protein responsible for nail strength.
Other diseases affecting the nails
In addition to kidney disease, nail changes may indicate other health issues, including thyroid disease, diabetes, psoriasis, liver disease, Reiter's syndrome, inflammatory bowel disease, lung problems, and heart disease.
It is crucial to mention significant nail changes to your doctor as these symptoms could lead to quicker, more accurate assessments and treatments, no matter the cause.
When to contact a physician
Although there may be a connection between nail health and kidney disease, changes in the physical appearance of your fingernails or toenails are insufficient to assess any medical condition. However, significant alterations or shifts in appearance could warrant a doctor's visit.
If these symptoms are combined with other common kidney disease symptoms, such as insomnia, muscle cramps, blood in your urine, irregular urination, or breathing problems, contact your doctor immediately.
If you or someone you love has been diagnosed with kidney disease, Reset Kidney Health can help. We know from experience that, although kidney disease is not reversible, early treatment saves lives. With Reset, you can easily schedule appointments with world-class kidney specialists to get exceptional treatment from the comfort of your home. We are now accepting new patients, so book an appointment today.
