Diagnosis Urine sulfosalicylic acid test or urine protein electrophoresis (myeloma kidney) Biopsy (glomerulopathy) Diagnosis of myeloma-related kidney disease is suggested by the following combination of findings: Renal insufficiency Bland urine sediment Negative or trace-positive dipstick for protein (unless urine albumin is elevated in a patient with an accompanying nephrotic syndrome) Elevated total urinary protein The diagnosis should be suspected even in patients without a history of or findings suggesting multiple myeloma, particularly if total urinary protein is elevated out of proportion to urinary albumin.