Hello, @formydad. Wish I could provide some answers. I can tell you that smoking affects the respiratory system which affects the heart which affects the kidneys. I'm not a doctor but my personal opinion is that even if smoking may not have caused the problem it didn't help it, either. I don't remember some of the details you shared about your dad as to whether he is diabetic or overweight or has a family history of cancer or kidney disease but I suspect there are many such factors or similar ones involved. Please keep us posted re his test results. I am sending you positive vibes!