One usual sign of pre-eclampsia is proteinuria, caused by increased permeability of the glomeruli - another manifestation of the endothelial effects of PET. It is a relatively advanced sign, and is essentially the nephrotic syndrome.
Reduced renal perfusion leads to reduced GFR and thus reduced creatinine clearance. Uric acid clearance doubles in normal pregnancy from 6 to 12 ml/min; it falls in PET, such that there is hyperuricaemia - a diagnostic indicator in PET.
Proteinuria is a late sign of pre-eclampsia. The amount of proteinuria may be gross and reach values of 10-15g/day.
The renal problems can progress to acute renal failure; tubular necrosis is refractory, but there can be no recovery from cortical necrosis.
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