A 20-year-old man with chronic renal failure had a whitish smooth plaque on his tongue. Due to his long standing illness, he had poor oral hygiene. Histopathologic examination showed marked epithelial thickening with parakeratosis and intracellular edema in the prickle cell layer. PAS staining revealed increased amounts of PAS-positive materials in the pale epithelial cells. His tongue lesion persisted during his hospital course.