EDN1 and endothelial dysfunction: Therefore, during sepsis, elevated levels of ET-1 can be identified, leading to endothelial dysfunction (which, in turn, contributes to the worsening of other preexisting conditions, such as vascular complications in diabetes or cardiovascular diseases) [12], but studies show that this also determines renal vasoconstriction and hypoperfusion, leading to dysregulated electrolytes and metabolic acidosis.