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Isotopic methods are very reliable but can only be applied in a hospital setting.15,16 It is very probable that in the near future, we will see a more common use of GFR measurement by iohexol, which seems very reliable but is not yet widespread.17 There are other methods that can be used to evaluate kidney disease in patients with diabetes: (a) Reno-vesical ultrasound: some studies suggest ultrasonographic data that may give rise to suspicion of the presence of nephropathy as well as to make a differential diagnosis with other causes18,19 or (b) other biomarkers in the early detection of kidney disease in patients with diabetes,20–28 such as inflammation, endothelial dysfunction and urinary and tubular markers, GWAS genetic studies and others (cystatin, NAG, NGAL, KIM-1, IL-6, Netrin-1, thrombospondin-2, urinary glycans, urinary exosomes, VEGF, galectin-3, GDF-15, soluble TNF alpha)