Urinary biomarkers IGFBP-7 and TIMP-2 correlated negatively with eGFR and albumin, and positively with creatinine, plasma cell percentage, and LDH, highlighting their role in renal dysfunction and disease progression (Tables 1 and 2).Stratification by biomarker quartiles further confirmed their prognostic utility: patients in the highest quartiles of PVR expression, serum amylase, and urinary IGFBP-7 showed higher ISS stage, TP53 mutation frequency, and worse survival outcomes (Table 6). Here, ALB is linked to Abnormal renal physiology.