The findings of the present study demonstrate that U IGFBP-7/creatinine and U TIMP2/creatinine ratios and serum transgelin levels have predictive value for renal insufficiency, a finding also reported by Woziwodzka et al. According to previous studies, the measurement of urinary NGAL levels may have utility as a more accurate predictor of RI in MM than serum levels as patients with renal involvement have higher urinary levels of NGAL and urinary FLC levels which are associated with eGFR [18]. Here, TIMP2 is linked to Renal insufficiency.