Chronic kidney disease (CKD) can cause changes to your hair and nails, especially when paired with dialysis treatment.* When your outward appearance is impacted, you may feel self-conscious. Fortunately, some steps can be taken to help preserve your hair and nail health.

How does CKD affect your hair?

Hair breakage and hair loss can occur with CKD. These problems can begin before starting dialysis and also afterward. In contrast, people who do not suffer from CKD may lose their hair for other reasons, such as aging, stress, or heredity.

How are your nails affected?

Changes to one’s nails may also occur. These changes can include color, shape, texture, and thickness. People with CKD do not remove waste products as effectively. As such, nitrogen waste products, for example, build up and lead to damaged fingernails and toenails.

This may present as:

• Yellow or opaque coloring
• Brittle nails
• Pitted nails (easily breaking or falling off)
• Linear depressions across the fingernail (Beau’s lines)
• Ridge-shaped nails
• Raised ridges that are thin and concave (koilonychia)
• White streaks and/or spots on the nails (leukonychia)

Why does this occur?

Hair and nail health can decline for various reasons, which include:

• Malnutrition
• Vitamin deficiencies
• Side effects of certain CKD medications

One such example is protein intake in people who undergo dialysis, a treatment during which protein is lost. Moreover, dialysis can contribute to a loss of appetite, so you may be consuming a less than adequate amount of protein, such as meat, poultry, fish, and eggs. Protein is an important and necessary macronutrient for hair and nail health.

People with CKD are also at risk of deficiency in zinc, calcium, iron, and B vitamins. A renal dietitian might suggest that patients take a renal vitamin containing high levels of B vitamins. Calcium and iron levels can be tested through regular blood work, and supplements may be prescribed if levels become too low.

Your medications may be causing changes to your hair and nails, too. Do not stop taking anything you’ve been prescribed until your talk to your doctor. They can change your medications and/or add a medication or supplement to help you manage any unwanted symptoms.

How can I deal with these temporary changes?

If you begin to notice any changes to your hair and nails, tell your healthcare team. They may start with lab work to detect abnormal levels in your blood, including your thyroid, which can cause alterations to your hair, skin, and nails.

In most cases, hair loss is temporary for dialysis patients, and hair will begin to grow back after a couple of months of no dialysis. To preserve your hair and nail health during this vulnerable time, consider taking the following steps:

• Avoid perms and coloring. (Both can be too harsh.)
• Don’t use tight rubber bands in your hair.
• Consult your hairstylist on ways to mask thinning hair.
• Eat the right amount of protein. (Talk with your dietitian about your individualized needs, i.e., how many grams per day is right for you.)
• Take your renal vitamin as prescribed.

Make sure to keep your dialysis team apprised of any changes that impact your overall quality of life. It’s equally as important to avoid managing the symptoms on your own to prevent any further damage to your kidneys and to consult your doctor first.

*DaVita Kidney Care. (n.d.). Hair, Nails and Chronic Kidney Disease. https://www.davita.com/education/kidney-disease/symptoms/hair-nails-and-chronic-kidney-disease