A 68-year-old woman with end-stage kidney disease due to hypertension presented with nausea, vomiting, dyspepsia, and epigastric pain. Endoscopy revealed varying numbers of 1 -3-mm diameter, white, flat plaques in the gastric body (• " Fig. 1) . Laboratory results included the following (normal ranges are given in brackets): blood urea 86.2 mg/dL (6.0 -21.0 mg/dL);