Bio

Murilo Guedes, MD, PhD, is a resident physician in Internal Medicine and part of the Translational Investigator Program (TIP) at Stanford.

All Publications

  • International variations in chronic kidney disease patients' pain experience and its management. Clinical kidney journal Raina, R., Nair, N., Kumar, R., Doshi, K., Alencar-de Pinho, N., Tu, C., Bieber, B., Liabeuf, S., Combe, C., Reichel, H., Argyropoulos, C., Guedes, M., Pecoits-Filho, R. 2026; 19 (1): sfaf346

    Abstract

    Background: Chronic pain significantly impacts health-related quality of life (HRQOL) in patients with non-dialysis chronic kidney disease (ND-CKD), yet the management of pain in this population is challenging. We hypothesized that analgesic prescription practices vary internationally, influencing the pain experience and HRQOL of patients with stage 3-5 ND-CKD.Methods: This descriptive, observational, multinational cohort study utilized data from the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps), enrolling adult patients from nephrology practices in Brazil, France and the USA between 2013 and 2020. Analgesic prescriptions within 6months before HRQOL assessment were categorized as non-steroidal anti-inflammatory drugs (NSAIDs), opioids or other analgesics. HRQOL was measured using the Kidney Disease Quality of Life Short Form, assessing multiple subdomains.Results: Among 3945 patients, analgesics were most frequently prescribed in the USA across all CKD stages, with opioids prescribed nearly twice as often compared with Brazil and France. NSAIDs are frequently prescribed in Brazil, including in advanced CKD stages, contrasting sharply with practices in France and the USA. Higher reported pain intensity consistently correlated with poorer outcomes across all HRQOL subdomains.Conclusions: This study identifies considerable international variability in pain reporting and analgesic prescription patterns in patients with stage 3-5 ND-CKD. Randomized controlled trials evaluating the efficacy and safety of analgesics are warranted to improve key patient-reported outcomes such as pain in patients with ND-CKD.

    View details for DOI 10.1093/ckj/sfaf346

    View details for PubMedID 41498063

  • Systematic Review of the Effects of Iron on Cardiovascular, Kidney, and Safety Outcomes in Patients With CKD KIDNEY INTERNATIONAL REPORTS Chan, B., Varghese, A., V. Badve, S., Pecoits-Filho, R., Guedes, M., Arnott, C., Kozor, R., O'Lone, E., Jun, M., Kotwal, S., Block, G. A., Chertow, G. M., Solomon, S. D., Vaduganathan, M., Perkovic, V., Neuen, B. L. 2025; 10 (4): 1037-1049

    View details for DOI 10.1016/j.ekir.2025.01.029

    View details for Web of Science ID 001468597200001

  • Systematic Review of the Effects of Iron on Cardiovascular, Kidney, and Safety Outcomes in Patients With CKD. Kidney international reports Chan, B., Varghese, A., Badve, S. V., Pecoits-Filho, R., Guedes, M., Arnott, C., Kozor, R., O'Lone, E., Jun, M., Kotwal, S., Block, G. A., Chertow, G. M., Solomon, S. D., Vaduganathan, M., Perkovic, V., Neuen, B. L. 2025; 10 (4): 1037-1049

    Abstract

    Heart failure and chronic kidney disease (CKD) are closely associated, and iron deficiency is highly prevalent in both conditions. However, major cardiovascular and nephrology guidelines offer contrasting recommendations for iron use. We evaluated the effects of iron versus usual care or placebo on the clinical outcomes in patients with CKD.We conducted a systematic review and meta-analysis of randomized trials on i.v. or oral iron in patients with CKD (PROSPERO CRD42023453468). We searched Medline, Embase, and the Cochrane Register from database inception until February 1, 2024 to identify eligible trials. We determined the overall results and stratified them by dialysis- and nondialysis-requiring CKD using random effects models, with certainty of evidence assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. The primary composite endpoint was hospitalization for heart failure or cardiovascular death.We identified 45 trials that met the inclusion criteria. Compared with usual care or placebo, iron reduced the risk of the primary composite endpoint (1659 events; risk ratio [RR]: 0.84, 95% confidence interval [CI]: 0.75-0.94; moderate certainty), an effect consistent across dialysis and nondialysis requiring CKD (P-heterogeneity = 0.70). The effect on the primary endpoint appeared driven by both components of hospitalization for heart failure (RR: 0.77; 95% CI: 0.61-0.96; moderate certainty) and cardiovascular death (RR: 0.81; 95% CI: 0.65-1.02; low certainty). The incidence of serious adverse events was lower for iron compared with usual care or placebo (RR: 0.90, 95% CI: 0.82-0.98; moderate certainty; P-heterogeneity = 0.09).Iron therapy may reduce the risk of heart failure and cardiovascular death in patients with CKD. Randomized trials evaluating the effects of iron on clinical outcomes are needed, especially in nondialysis patients with CKD with or without anemia.

    View details for DOI 10.1016/j.ekir.2025.01.029

    View details for PubMedID 40303218

    View details for PubMedCentralID PMC12034885