Task: Translation
Input (English): Question linked to image nº11 A 68-year-old man who consulted due to asthenia. He refers to bone pain as the only accompanying symptomatology. His kidney function was normal 6 months earlier. General analytical is performed, which shows creatinine 2.0 mg / dL, urea 86 mg / dL, plasma proteins 90 g / L, ESR 120 mm / h, urinary albumin / creatinine ratio 4 (normal), urinary protein / creatinine ratio 80 (N <22). The image of the urine sediment and the urine dipstick is attached. What suspicion can the patient have and what test would he do in the first place?
Output (Spanish): Pregunta vinculada a la imagen nº11 Hombre de 68 años que consulta por astenia. Refiere dolores óseos como única sintomatología acompañante. Su función renal era normal 6 meses antes. Se realiza analítica general que muestra creatinina 2,0 mg/dL, urea 86 mg/dL, proteínas plasmáticas 90 g/L, VSG 120 mm/h, ratio albúmina/creatinina urinaria 4 (normal), ratio proteína/creatinina urinaria 80 (N<22). Se adjunta la imagen del sedimento de orina y de la tira reactiva de orina. ¿Qué sospecha que pueda tener el paciente y qué prueba haría en primer lugar?