Specific organ systems respond to traumatic shock in specific ways:
The kidney and adrenal glands are prime responders to the neuroendocrine changes associated with shock; these organs produce renin, angiotensin, aldosterone, cortisol, erythropoietin, and catecholamines.
The kidney itself maintains glomerular filtration in the face of hypotension by selective vasoconstriction and concentration of blood flow in the medulla and deep cortical area.
Prolonged hypotension leads to decreased cellular energy and an inability to concentrate urine(renal cell hibrination), followed by patchy cell death, tubular epithelial necrosis, and renal failure
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The heart is relatively preserved from ischemia during shock because of an increase in nutrient blood flow
