Can injected procaine cause impaired renal function?

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Last updated: July 3, 2025View editorial policy

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From the FDA Drug Label

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function Urogenital: Nephropathy... renal failure

Injected procaine may cause kidney issues, including impaired renal function, nephropathy, and renal failure, particularly in patients with pre-existing renal impairment.

  • Key points:
    • Procaine is substantially excreted by the kidney.
    • Risk of toxic reactions is greater in patients with impaired renal function.
    • Adverse reactions include nephropathy and renal failure. 1 1

From the Research

Injected procaine is unlikely to cause significant impaired renal function when used appropriately, but it may affect kidney function in certain individuals, particularly those with pre-existing kidney disease or receiving high doses. Procaine is a local anesthetic that works by blocking nerve signals in the body and is typically used for local or regional anesthesia. When administered in standard therapeutic doses, serious renal complications are rare. However, procaine can affect kidney function through several mechanisms, such as causing hypotension, which can reduce blood flow to the kidneys and impair their function 2. Additionally, in some individuals, procaine may trigger allergic reactions that can affect multiple organ systems, including the kidneys. Patients with pre-existing kidney disease, the elderly, or those receiving high doses are at greater risk for developing renal complications. Signs of kidney impairment may include decreased urine output, fluid retention, or abnormal laboratory values.

  • Key points to consider:
    • Procaine can increase peritoneal clearance of urea and inulin in peritoneal dialysis, suggesting a potential beneficial effect on renal function in certain contexts 3.
    • Procaine and its metabolites may protect against cisplatin-induced kidney damage by inhibiting mitochondrial lipid peroxidation 2.
    • The use of procaine in cold preservation fluid for living donor kidney transplantation has been shown to be effective and safe, with no identifiable side effects attributed to the procaine solution 4. Healthcare providers should monitor kidney function in patients receiving procaine, especially those with risk factors, and adjust dosing accordingly. If kidney function changes are noted after procaine administration, the medication should be discontinued and appropriate supportive care provided.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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