Kidney Disease Nails: Doctors Share the Early Warning Signs

There’s a reason the kidneys are sometimes called the “unsung heroes” of the body. They act as a filtering system, removing waste and excess fluid. And they do an incredibly efficient job . In fact, your kidneys filter all the blood in your body every 30 minutes. They also help maintain electrolyte balance and regulate blood pressure. So when kidney function is impaired, it can lead to a bevy of other issues. But how can you tell if your kidneys are chugging along normally? When it comes to kidney disease, nails can surprisingly offer critical clues that something is awry. Here’s what you need to know about the link between kidney disease and your nails.

What is kidney disease?

In those with chronic kidney disease (CKD), kidney function slows down, which allows extra waste and fluids to linger in the body. This can lead to serious health issues such as kidney failure or cardiovascular disease.

According to the CDC, around 15% of adults in the US have chronic kidney disease. Your risk increases significantly after age 60, or if you have diabetes or high blood pressure. “We know the top causes of kidney disease are diabetes and hypertension, which can lead to chronic kidney disease and potentially dialysis,” says Ndidi Nwamu-Laguerre, DO, a nephrologist and physician aesthetician at Delta Kidney & Hypertension.

But most people with chronic kidney disease don’t even realize they have it. Kidney disease is often “silent,” or asymptomatic, in its early stages. That’s why it’s so important to get routine testing for kidney function and take note of any subtle early warning signs of kidney disease. And that includes keeping an eye on your nail health, since certain changes to your nails can be common markers for kidney disease.

The link between kidney disease and your nails

We tend to think of fingernails and toenails as cosmetic, but the health of your nails can offer clues to your overall wellbeing. “With kidney disease, you have a decreased ability to clear the toxins in your body,” Dr. Nwamu-Laguerre says. “The toxins start to circulate through the blood, and the nail beds are fed by the blood continuously. This toxic blood can have its way with the nails.”

Over time, that can lead to changes in the color, shape, texture and strength of your nails. “You might notice your nails getting thin, brittle or turning yellow,” says Raj Dasgupta, MD, an internal medicine physician and chief medical advisor for Fortune Recommends. “Sometimes you’ll notice half-white, half-brown nails or deep grooves across them.”

Changes in your nails that may signal kidney disease

Not sure what exactly to look for? Here are a few ways kidney disease can affect your nails:

1. “Half and half” nails

Nails may be pale near the nail bed and reddish-brown near the fingertips, a condition known as Lindsay’s nails. This is one of the most common ways kidney disease can affect the nails. Between 20% and 50% of patients with CKD have this type of discoloration.

2. Pale white bands

Pale, parallel bands that run horizontally across the nail and fade temporarily when you press on them are known as Muehrcke’s nails. These can signify low levels of a protein called albumin, but they can also be a symptom of kidney disease or kidney failure.

3. Bright white streaks

Mees’ lines are also white lines that run across the nail bed, but they tend to be a single streak that doesn’t fade when pressed. This can be a sign of kidney failure. If you notice streaky white toenails or fingernails, let your doctor know.

4. Yellow nails

“Issues with your kidney function can lead to anemia, making your nails pale or have a yellow tint,” Dr. Dasgupta says. Advanced kidney problems can cause uremia — a buildup of waste products in the blood — which can also turn nails yellow, he adds.

5. Blood spots

“If you see little blood spots, these are called splinter hemorrhaging, and you should take notice,” Dr. Nwamu-Laguerre says. This can be a sign of chronic kidney disease caused by high blood pressure.

6. Separation

In patients with kidney disease, nails may separate from the nail bed and become cloudy in appearance. This can have an innocuous explanation (like an injury to the nail or a reaction to a nail care product), but it can sometimes signal CKD. “Swelling around the nails from fluid retention is also common, making them look curved or even lifting them away from the nail bed,” Dr. Dasgupta explains.

7. Beau’s lines

These deep, horizontal depressions across the nail bed occur when something disrupts your nail growth, like an injury, illness or extreme stress. Beau’s lines may also be a symptom of acute kidney disease, a type of kidney condition that develops rapidly. Acute kidney disease can be fatal if not treated, so if you notice these lines and can’t think of an obvious cause (like a recent injury), let your doctor know ASAP.

8. Clubbing

If your nails appear rounded, swollen or bulging, like an upside-down spoon, that can signal an underlying condition. “Clubbing is something we commonly see in smokers, because hypoxia — the lack of oxygen — causes the nail bed to curve and begin to club,” Dr. Nwama-Laguerre says. However, this typically only happens in cases of chronic kidney failure or dialysis patients.

If you notice any of these changes, let your doctor know. A simple blood or urine test can gauge your kidney health.

More early warning signs of kidney disease

If your nails aren’t looking their healthiest, don’t go straight into panic mode. There are plenty of much-less-daunting conditions that can affect the appearance of your nails, like a vitamin deficiency, frequent hand-washing or even removing acrylic polish.

However, if you notice any of the nail changes above, be on the lookout for these additional early warning signs of kidney disease:

Fatigue
Sleep issues
Difficulty concentrating
Dry, itchy skin
Frequent urination
Blood or bubbles in the urine
Puffiness around the eyes
Swollen feet and ankles
Low appetite
Muscle cramps

Learn more about the symptoms of chronic kidney disease with the video below:

3 tips to keep your kidneys healthy

Chronic kidney disease is relatively common, but luckily there are simple lifestyle habits that can help to limit your risk.

1. Hit the sleep “sweet spot”

Sleep is a pillar of health, and that includes kidney health. A review in the World Journal of Nephrology found a strong association between sleep disorders and kidney disease. More research is needed to understand exactly how sleep affects kidney health, Dr. Dasgupta says, but “sleep deprivation has been associated with heightened risks of conditions like hypertension, diabetes, cardiovascular diseases and obesity, all of which are recognized as contributing factors to CKD.”

For optimal kidney health, aim to get between 7 and 8 hours of sleep each night. Of course, that may be easier said than done. If you struggle with insomnia, these tips can help you get a better night’s sleep:

Turn your thermostat down. “Make sure your sleeping environment is dark, quiet, and cool,” Dr. Dasgupta says. The ideal room temperature for sleep is 65 to 68 degrees.
Be consistent — go to bed around the same time each night, and set your alarm for the same time each morning.
Cut off caffeine at least six hours before bed, and avoid alcohol at least four hours before bed. “They can impede sleep onset and disrupt sleep later in the night,” Dr. Dasgupta says. Instead, sip a calming herbal tea, like chamomile or lavender, he suggests.

2. Swap your tipple

We’ve all heard the jokes about spraining a liver after one too many drinks, but alcohol can also be surprisingly taxing on your kidneys. In fact, frequent heavy drinking can double your risk of kidney disease. To keep trouble at bay, stick to one alcoholic drink per day.

Even better: Consider swapping your daily tipple for a kidney-supporting sip. “Green tea and cranberry juice may help with kidney function, but there is limited evidence to support this,” Dr. Dasgupta says. In particular, green tea contains epigallocatechin 3-gallate (EGCG), a compound with powerful antioxidant properties that eases inflammation and oxidative stress — both of which have been linked to CKD.

Tip: If you don’t love plain tea, try making it into a mocktail. Tea is actually an ideal mocktail mixer because the bitter flavor of over-steeped tea can replicate the taste of alcohol.

3. Spin your spice rack

mature woman organizing spices on a kitchen countertop — Getty

“Consuming too much sodium can put extra stress on your kidneys by making them filter more fluid,” Dr. Dasgupta says. “Over time, this extra strain can negatively impact your kidney function. High sodium intake is also related to hypertension and cardiovascular diseases, which can worsen kidney issues.”

Adults should keep their sodium intake under 2,300 mg per day. To help cut back, flavor your food with spices instead of salt. (Discover which spice brands have the fewest toxins — your kidneys will thank you!)