Some patients with renal insufficiency and anemia are often seen in the nephrology department, especially those who only show proteinuria at the beginning, but are not found to have “multiple myeloma” until they have renal failure and are hospitalized to improve immunoglobulin and bone marrow tests. After being referred to the hematology department for effective treatment, most of the patients’ renal function quickly returned to normal. Multiple myeloma is a malignant disease with abnormal proliferation of clonal plasma cells. Clinical manifestations include bone disease such as bone destruction, bone pain or fracture, anemia, renal insufficiency, hypercalcemia, and target organ damage related to amyloidosis. The disease can lead to immune deficiency and is prone to complications such as pneumonia and pyelonephritis. The disease starts slowly Some patients may be asymptomatic for a long time and have a variety of clinical manifestations, so they may go to nephrology, orthopedics and respiratory medicine in the early stage, which is easy to be misdiagnosed, and only after the treatment is not effective can they think of this disease and refer to hematology. Currently, due to the increase of elderly population, the incidence of multiple myeloma is also increasing, and it is the 2nd most common malignant tumor in the hematological system, mostly seen in the elderly. Its etiology, like that of other malignancies, is still unknown. Without treatment, the survival period is only 6-12 months. With the introduction of new drugs and improved detection techniques, survival has improved significantly. According to the risk stratification of the International Myeloma Working Group, low-risk patients, median survival after treatment is >10 years, intermediate-risk patients median survival after treatment is 7 years, and high-risk patients median survival after treatment is 2 years. 60% of patients are intermediate risk at the time of presentation. Therefore, for patients with renal insufficiency and anemia, in addition to kidney disease, the possibility of multiple myeloma also needs to be considered, and after a clear diagnosis, standardized treatment under the guidance of a specialist is required. Modern treatment measures have saved the lives of many patients and improved the quality of life. However, the prerequisite is to diagnose and detect early and not to delay the treatment.