A 62-year-old diabetic patient came to the outpatient department due to increasing tiredness in the past few months. On examination, his distal half of fingernails revealed pinkish red transverse band which is sharply demarcated by a dull white band proximally, consistent with half and half nail. Further evaluation showed evidence of chronic kidney disease due to long standing poorly controlled diabetes. Although half and half nail is seen in many conditions, it is relatively a specific clinical marker of end stage kidney disease and hence serves as an important diagnostic clue.
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