Abstract: OBJECTIVE：To investigate diagnostic and prognostic values of multi-biomarker detection in patients with early renal damage due to multiple myeloma (MM). METHODS：From November 2018 to May 2023，newly diagnosed MM patients admitted to the Department of Hematology of the Fourth hospital of Hebei Medical University were recruited as study subjects. According to the blood creatinine (SCr) detection level， the patients were divided into two MM groups with or without kidney injury，and the clinicopathological data， blood routine， coagulation function， biochemistry and other related laboratory detection indicators were collected. In addition， 30 healthy volunteers without benign or malignant tumors nor cardiovascular diseases were selected as the control group. The ROC curve was drawn to evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR)， monocyte-to-lymphocyte ratio (MLR)， systemic inflammation response index (SIRI) and fibrinogen-to-albumin ratio (FAR) in the occurrence of kidney injury in MM patients，and the correlation with tumor stage and tumor load of MM patients was analyzed. RESULTS： From our recruitment， 95 patients and 30 controls were selected. The levels of NLR， MLR， SIRI and FAR in MM patients with kidney injury were significantly higher than those in control group and MM patients without kidney injury group (P<0.05). ROC curves showed that NLR，MLR，SIRI and FAR had predictive value in MM patients with kidney injury (P<0.05). Combined detection using the four biomarkers showed higher diagnostic values for the MM patients with kidney injury. Logistic regression analysis showed that the level of NLR， MLR， SIRI and FAR were closely related to the occurrence of kidney injury in MM patients. High NLR was an independent risk factor for kidney injury in MM patients. Chi-square test results showed that MLR was closely correlated with ISS stage in MM patients (P<0.05). CONCLUSION：NLR，MLR，SIRI and FAR showed value in the diagnosis of kidney injury in MM patients. Combined diagnosis improved the diagnostic efficiency，and provided a basis for the application of inflammatory markers in the clinical diagnosis and treatment of MM patients with kidney injury.

Key words: renal damage in multiple myeloma, tumor biomarker, NLR, MLR, inflammation indicators