How to diagnose myeloma in a person who has high blood pressure and high creatinine levels?

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Your albumin and total protein levels are within the limit. But the A/G ratio is mildly decreased. Normally, it should be more than 1.5. So, your globulin level might be altered leading to decreased A/G ratio. You can suspect multiple myeloma if any other supportive finding for multiple myeloma is present like osteolytic bone lesion, hypercalcemia, high ESR (erythrocyte sedimentation rate), bone pain, recurrent infection, low Hb (hemoglobin), and so on.

For further workup (if multiple myeloma is suspected), you can do a serum or urine immunofixation electrophoresis. If it shows an M spike, then bone marrow aspiration should be done to confirm multiple myeloma. Kindly let me know if any clinical complaint is present or if any of the above supportive signs are present.

I wish you good health.

Thank you.