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Treatment of type II diabetes.

SIR,-The views of Dr Carolyn D Ritchie and her colleagues (8 March, p 681) and Mr Nigel Bullock (p 645) illustrate the disparity which exists in the approach of urologists and nephrologists to this common clinical problem. Dr Ritchie and colleagues describe "full" investigation of patients with microscopical haematuria as comprising intravenous urography and cystoscopy. No mention is made of renal biopsy. Mr Bullock proposes that isolated microscopical haematuria may not require further investigation in a young adult after full urological assessment. Furthermore, he suggests that ifsuch a patient has glomerular disease it will carry a uniformly good prognosis in the absence ofother urinary sediment abnormalities and hypertension. Thus renal biopsy is not necessary. We believe his premise to be false and illustrate our point with the following case.