A basic metabolic panel can provide information about electrolytes and kidney-related markers. Other commonly reviewed results include blood urea nitrogen, or BUN, creatinine, and estimated glomerular filtration rate, or eGFR. An eGFR below 60 may indicate reduced kidney function when it persists for three months or longer, but only a healthcare professional can interpret the result in context.
Brittle nails can also result from frequent handwashing, harsh chemicals, dehydration, fungal infections, thyroid disease, or inadequate nutrition. Rapid weight loss and appetite changes may increase the risk of nutritional deficiencies, particularly when medications or restrictive diets are involved. If your nails are changing and you do not know why, discuss the issue with your clinician instead of assuming it is kidney disease.
3. Terry’s nails
Terry’s nails are characterized by a nail that appears mostly white or pale, with a narrow pink, reddish, or brown band near the tip. In many cases, the pale portion covers most of the nail, while the contrasting band is located at the distal edge.
This pattern has been associated with advanced kidney disease, but it can also occur with liver disease, heart failure, diabetes, and aging. One possible explanation is a combination of changes in blood flow and low levels of albumin, a major protein in the blood. Kidney disorders that cause significant protein loss through the urine may lower blood albumin levels.
If a clinician sees Terry’s nails, they may consider checking kidney function, liver function, blood counts, and nutritional markers. Urine testing can also determine whether you are losing excess protein. One useful test is the urine albumin-to-creatinine ratio, commonly called the UACR.
Terry’s nails are not an emergency by themselves, but they should not be ignored—particularly if you also have swelling in your ankles, foamy urine, unexplained fatigue, or a history of high blood pressure or diabetes.
4. Half-and-half nails, also called Lindsay nails
Half-and-half nails are one of the more distinctive nail patterns associated with chronic kidney disease. The lower portion of the nail near the cuticle appears pale or white, while approximately the upper half has a darker pink, red, brown, or tan color. The boundary between the two areas can be fairly clear.
This appearance has been reported in people with chronic kidney disease, especially those with more advanced disease. The exact cause is not completely understood, but it may involve changes in the nail bed, circulation, pigment, and the body’s handling of waste products and minerals.
Because this pattern can be subtle, many people dismiss it as a normal variation or a cosmetic issue. If you notice a persistent half-and-half appearance on several nails, take a clear photograph in natural light and show it to your healthcare professional. They may recommend a creatinine test, eGFR, electrolyte measurements, urinalysis, and a UACR.
