nail color and kidney problem?

Question
Dear Dr.Dr. Shamik Shah, MD, DNB (Nephrology), ISN Fellow  ,

                    I have some problem in my nails.I have seen pink on the top of the nail and  whitish on the nail bed area in   my index (last small finger) in one hand.When i press the nail the red color vanishes and nail has been seen whitish but after relaeses my pressure again color return to pink and white. After the nail edge everybody has some brown line (horizontal) but in 4 finger this line increased for me.when I pressed those nails ,the color vanishes and nail is white.I have consulted three skin specialist and nobody seems to find right solution.I also consulted heart specialist to clear the suspect about splinter haemorrhage but he told my heart is good and this is not splinter haemorrhage. I also tested kidney ,liver ,hemoglobin,vit b12 everything seems to be in normal range.Is this due to any kidney problem.Three occations I have tested kidney function test but everything normal.This problem started within 4-5 month.I have given my test results.Do you recommend any further test on kidney ? I have taken abtomen complete ultrasound and again everything normal but that time nail when my nails are good. I dont have any pain in stomach area.My dont have any urinery problem .I have started to do tumbles exercise for my hand for the past 5 month.I am lifting one kg weight only per hand.also for the past 6 month in our family purchasing Water (Reverse osmosis purified) cane from reputed supplier.In the Website for nail disorder I have seen this type of pink and white may be due to kidney illness so I am nervous.

Lab results

    

Blood haematology

haemoglobin :               Results of mine                           

method:SLS -automated         15.3 gm/dl    ref range:male 13.5 -17gm/dl

Blood bichemistry

urea

method:GLDH/Urease   20.6mg/dl   ref:        13-45 mg/dl

creainine

Method :Jaffe's kinetic        0.98 mg/dl  ref: 0.7-1.2 mg/dl



Liver function test

bilirubin total          0.6 mg/dl    ref range: 0.3 -1.2 mg/dl

bilirubin direct         0.16 mg/dl    ref:    

bilirunin indirect       0.44 mg/dl  

S.G.O.T(AST)             18.6   U/L      ref:MALE :UPTO 38 U/L

S.G.P.T(ALT)            14.3 U/L        ref: MALE UPTO 41 U/L





ALKALINE PHOSPHATE    91 IU/L           ref: 40 -130 U/L



A/G RATIO

TOTAL PROTEIN      7.7 gm/dl            ref:  6 -8.3 gm/dl

Albumin            5 gm/dl              ref:  3.2-5 gm/dl

globulin            2.7 gm/dl            ref:  2.3-3.5

A/G ratio           1.9



Vitamin B12        306.9 pg/ml       ref: normal    211-946 pg/ml

 method eclia                            deficient less than 211 pg/ml                            





Regards,

Vikram.D


Answer
Hi Vikram,



Thanks for asking my help on "Allexperts".



Nitrogen waste products build up in people with chronic kidney disease, which can lead to damaged fingernails and toenails. Your lab results for kidney function are within normal limits, so I would not worry too much.



Without examining you, it wouldn't be possible for me to comment on your nails. It is recommended to show your doctor if you have any abnormal change in your nails. Here are some specific changes that may occur:



   * Yellow or opaque coloring

   * Brittle nails

   * Pitted nails (can easily break off or fall off)

   * Linear depressions across the fingernail (called Beau?s lines)

   * Ridge-shaped nails

   * Raised ridges, thin and concave shaped (called koilonychia)

   * White streaks, spots on the nails (called leukonychia)



Sincerely,



Dr. Shah