I think Renji is mad because Sakuma rejected Renji’s pheromones. The reason Sakuma had that reaction is because Sakuma encountered an alpha who is his “fated mate” (though in this manga they just say it’s an alpha and omega who are especially compatible). The reasoning they give is that an omega who is exposed to a “fated mate’s” pheromones rejects any other alpha’s pheromones. It seems like Renji and Sakuma aren’t fated mates :(
WAIT I think I got it—so, Sakima is 'destined' match with the attacker and Renji, as the doctor also stated, thinks that Sakima's health problems happened due to his angry (tho any pheromone release would have done it i suppose) pheromones after, since it wasn't the 'destined' person's.
I think it'll probably end up with either it being like a new 'seldom' case of changing 'destined' person (since why would the whole 'breed me' situation while thinking of Renji be there if he rejected him) or that Sakima becomes strong enough to reject the attacker's pheremones, and then them becoming a pair will fix it. Second option would be more realistic to the world building, I just feel like some sort of twist is gonna happen ngl

So, Sakima rejected the attacker's pheromones, and Renji got mad at Sakima for getting hard/reacting before the rejection? Or did Sakima reject Renji's pheromones and that's why he panicked? I don't think I understand completely...