You may be surprised to learn that some symptoms of kidney cancer aren’t just internal. Some people with kidney cancer notice changes in their skin and nails. These changes may be caused by the cancer itself or by treatment.

Kidney cancer can damage the kidneys or affect how well they work, which may lead to skin or nail changes. Some kidney cancer treatments can also cause nail problems, such as pain, weakness, and cracking. Other nail changes may not be related to kidney cancer and can have other causes.

This article explains possible nail changes linked to kidney cancer and shares tips for caring for your nails during cancer treatment.

Nail Changes Related to Kidney Cancer

Kidney cancer can cause damage and loss of function in the kidneys. When kidney cancer affects kidney function, the kidneys may not be able to filter waste and balance fluids effectively. This can lead to a buildup of toxins in the blood.

Kidney problems can also lead to nutritional deficiencies. These changes in the body can affect the skin and nails and are common in people with advanced kidney disease, including those on hemodialysis.

If you’re living with kidney cancer, you may develop nail ridges or several other types of changes. Below, we discuss six ways kidney cancer or treatment may affect the nails.

1. Nail Ridges

Kidney damage related to kidney cancer may cause Beau’s lines. These horizontal grooves or ridges form across the nail bed when nail growth slows. They can affect both fingernails and toenails.

2. Half-and-Half Nails

Half-and-half nails, also called Lindsay’s nails, are common in people with reduced kidney function. The top part of the nail looks white, while the bottom part looks brown, red, or pink. Half-and-half nails may be a sign that your kidneys are not working properly.

3. Horizontal Lines

Another sign of kidney damage is Muehrcke lines. These horizontal white lines usually appear on the fingernails, except the thumbs. Most people have at least two lines on each affected nail.

Muehrcke lines can develop when levels of the protein albumin are low. This can occur when the kidneys are inflamed or damaged. These lines can also be a side effect of chemotherapy.

4. Nail Yellowing or Discoloration

Kidney cancer may cause changes in nail color. When the kidneys can’t filter toxins properly, the nails may become discolored, ranging from light yellow to dark brown. Kidney cancer may also cause changes in skin color.

5. Brittle or Pale Nails

Kidney problems and some cancer treatments can make the nails weak, brittle, or pale. Nails may grow slowly or stop growing for a time. Some chemotherapy drugs can also cause nails to loosen or fall off.

6. Metastasis

In rare cases, kidney cancer can metastasize (spread) to the skin or nails. This is uncommon but may happen with aggressive forms of kidney cancer.

Ways Kidney Cancer Treatments Can Affect Nails

If kidney cancer has spread to other areas of the body, you may need additional treatments such as radiation therapy, targeted therapy, immunotherapy, or chemotherapy (although less common for kidney cancer). Some of these kidney treatments can affect nail growth and structure.

Targeted Therapy

Targeted therapy uses drugs that attack specific proteins on cancer cells. Two types of targeted therapy that may cause nail changes are epidermal growth factor receptor (EGFR) inhibitors and vascular endothelial growth factor (VEGF) or angiogenesis inhibitors.

Targeted therapies may cause:

• Dark areas around the cuticles
• Hyperpigmentation (darkening or discoloration of the nails)
• Fissures (deep grooves or cracks in the nails)
• Inflammation (swelling) around the nails
• Nail lifting from the nail bed

Immunotherapy

Immunotherapy helps the immune system find and attack cancer cells. Immune checkpoint inhibitors are the type of immunotherapy most likely to cause nail changes.

Chemotherapy

Chemotherapy kills fast-growing cells in the body, including those involved in nail growth. Nail changes caused by chemotherapy are usually temporary and resolve within a few months after treatment ends. Although not usually serious, these changes can be uncomfortable or painful.

Chemotherapy may cause:

• Hyperpigmentation
• Splinter hemorrhages (thin red or brown lines under the nails)
• Inflammation around the nails
• Nail lifting from the nail bed
• Nail loss

Other Reasons Nails May Change

Nails can change over time for several reasons, including:

• Aging — Nails often become more brittle over time.
• Nutritional deficiencies — Not getting enough iron may cause thin fingernails with a spoon-shaped dip in the center.
• Infections — Signs of a nail infection may include discoloration, swelling, or nail lifting. A bacterial infection may turn the nail green or black.
• Injury — Damage to the nail bed can cause color changes, swelling, or nail lifting. Biting or picking nails can also cause damage over time.
• Medications — Some antibiotics can cause the nails to lift from the nail bed.

Other health conditions besides kidney disease can also cause nail changes, including:

• Skin cancer — A dark streak under the nail may be a sign of melanoma.
• Chronic skin conditions — Common conditions such as eczema and psoriasis can affect the nails, causing small dents called pitting. Psoriasis can also cause thick or overgrown nails.
• Heart disease — Chronic (long-term) heart disease can cause clubbing, a condition that makes the nails curve around the fingertips. Some lung, liver, and intestinal diseases can also cause clubbing.
• Thyroid disease — An overactive or underactive thyroid gland may cause nails to become brittle or split easily.

Tips To Manage Nail Changes and Protect Your Nails

Experiencing nail changes during kidney cancer treatment can feel uncomfortable, embarrassing, or distressing. Most nail changes aren’t serious, but it’s always best to discuss any new symptoms with your healthcare team. Your healthcare provider may be able to recommend treatments to improve the appearance and comfort of your nails.

Self-care tips to protect your nails include the following:

• Avoid biting or picking at your nails.
• Keep nails trimmed short, and clip hangnails carefully.
• Moisturize your nails after trimming them to help prevent splitting.
• Avoid nail polish until your nails heal.
• Avoid shoes that squeeze your toes together.
• Keep nails as dry as possible, and protect them from too much water exposure.
• Wear flip-flops in public showers, such as at pools or gyms, to prevent fungal infections.

Taking care of your nails can help prevent discomfort, lower the risk of infection, and support your overall well-being.

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What skin or nail changes have you had during your kidney cancer journey? Let others know in the comments below.