With more severe renal disease (eg, estimated glomerular filtration rate [eGFR] < 15 mL / min/1.73 m 2), neuromuscular symptoms may be present, including coarse muscular twitches, peripheral sensory and motor neuropathies, muscle cramps, hyperreflexia, restless legs syndrome, and seizures (usually the result of hypertensive or metabolic encephalopathy).