Background: Specific nail abnormalities, such as half-and-half nails (sometimes called Lindsay's nails), are frequently associated with chronic kidney disease (CKD). In 1963, William B. Bean first noted it in two of his renal illness patients. Half-nail deformities have a mysterious origin that has yet to be identified. It doesn't improve with dialysis, but it goes away completely following a kidney transplant. Objective: This study was aimed to shed light on study the predictive value of half-and-half nail for biochemical disorders in patients with CKD stage 5 and try to unveil its etiopathogenesis. Patients and methods: This case-control study included a total of 100 patients with chronic kidney disease, stage 5, classified into four equal groups, the first two groups were without hemodialysis, and One has regular nails, while the other has half-and-half nails, the second two groups were on hemodialysis and one without half and half nails and the other group with half-and-half nails. Results: According to kidney function tests and other laboratory results, this study found no statistically significant difference (p value >.05) between the study groups. Patients with half-and-half nails had a higher mean age and duration of hemodialysis, both of which were statistically significant (p