Hi there, Thanks for your query. Your boyfriend is presently in a critical state : has pneumonia-induced respiratory failure (and possibly, a compromised heart function); has probable septicemia (extension of infection into the blood and thereby, the entire body); freshly diagnosed diabetes with dangerously high sugar level, compounded by kidney failure; and, added risk factors : obesity + smoking. Though it is very difficult to predict the outcome, the prognosis appears poor. However, an aggressive treatment with effective antibiotics for infection, early control of blood sugar with insulin; aggressive treatment of diabetic complications and, above all, management of kidney failure would improve the survival rate to about 50%. If you find my response helpful and informative, do not forget an “excellent” (5-star rating) to my answer, to ENCOURAGE ALL doctors- engaged in social service- to render sound advice to the FREE queries. Take care Dr. Rakesh Karanwal