mrcem2-0493

A 70-year-old man presents to the Emergency Department acutely ill with abdominal and lower limb pain. He had a syncopal episode in the department and was transferred to the resuscitation area.

His initial blood results are as follows:
Na+: 114 mmol/l
K+: 7.1 mmol/l
Urea: 17.6 mmol/l
Creatinine: 150 mmol/l

What is the most frequent cause of the underlying diagnosis in this scenario?