Abnormalities in fingernail pigmentation were first reported in 1900 in the United States and soon after in England, the latter in association with arsenical beer poisoning (1). Since then, other conditions associated with nail pigmentation defects have included thallium poisoning, psoriasis, leprosy, fluorosis, trichiniasis, malaria, cardiac insufficiency, zinc deficiency, cancer chemotherapy (not with azathioprim), and one case of myocardial infarction (2-4). However, the association of striped nails or transverse striate leukonychia with renal disease has heretofore been described only when accompanied by hypoalbuminemia. In all such cases, with and without the nephrotic syndrome, the serum albumin level was below 2.2