Supraclavicular and carotid bruits in hemodialysis patients

Auscultation of the neck vessels in patients receiving chronic hemodialysis reveals a high incidence of subclavian and carotid bruits as well as the expected precordial hemic murmurs. These bruits are associated with the high-output hyperdynamic circulatory state. In older patients the finding could be misinterpreted as evidence of extracranial cerebrovascular disease, but clinical considerations should obviate unnecessary neuroradiological diagnostic procedures.