Chronic Kidney Disease Care in Hilo & Across Hawaiʻi — Medicaid (QUEST) Accepted

Chronic kidney disease (CKD) means the kidneys are gradually losing their ability to filter waste and fluid from the blood. It is common, especially alongside diabetes and high blood pressure, and in its early stages it usually causes no symptoms at all. Caught early, its progression can often be slowed substantially. At Ohana Care Clinic in Hilo, we screen for it, monitor it, and work to protect your kidneys.

What chronic kidney disease is

Your kidneys filter your blood, balance fluids and minerals, and help control blood pressure. In CKD, that filtering capacity declines slowly over months and years. The two most common drivers are diabetes and high blood pressure, which is why managing those conditions well is central to protecting the kidneys. Because the kidneys have spare capacity, people often feel fine until the disease is advanced, which is what makes screening so important.

Why it matters

Beyond the kidneys themselves, CKD raises the risk of heart disease and other complications. The encouraging part is that early detection changes the story: with the right care, many people keep stable kidney function for years and avoid or delay more serious problems. The goal of our care is to find it early and slow it down.

How we screen for and diagnose it

CKD is detected with simple tests: a blood test that estimates how well the kidneys filter (eGFR) and a urine test that checks for protein, an early marker of kidney damage. We screen people at higher risk, especially those with diabetes or high blood pressure, and the KDIGO 2024 guideline emphasizes using these tests together to assess risk and guide care.

How we treat and manage it

Management centers on protecting kidney function and the heart at the same time. That means controlling blood pressure and blood sugar, using medications shown to protect the kidneys, reviewing medications and doses for kidney safety, and addressing diet and lifestyle. The KDIGO 2024 guideline brings these pieces into a comprehensive plan, and we coordinate with kidney specialists when needed. Much of this monitoring and management works well by telehealth, with in-person visits for labs.

Culturally grounded care

We care for the whole person, in the spirit of lōkahi — balance and harmony among the connected parts of life: the body, the mind and emotions, the spirit, the ʻohana (family), and our relationship with the ʻāina (land) and community. In a Native Hawaiian understanding of health, these are not separate, and neither is our care. To mālama (care for and protect) your wellbeing and to live pono (in balance and rightness), we listen to your whole story, welcome your ʻohana into the process, and honor the values and traditions that ground you. Offering kōkua (help given freely, with aloha) in a way that respects who you are is at the heart of how we practice.

Insurance and how we see you

We accept Medicare and Medicaid, including the Hawaiʻi QUEST Integration plans (AlohaCare, the Hawaiʻi Medical Service Association (HMSA), ʻOhana Health Plan, and UnitedHealthcare Community Plan), along with most commercial insurance, and we are accepting new patients in Hilo. Primary care works best as a partnership. Your first visit is in person at our Hilo clinic. We see patients in person for physical exams, vitals, and lab work, and we use telehealth for follow-up visits, medication management, and chronic-disease check-ins whenever it is clinically appropriate.

Common questions about chronic kidney disease

What causes chronic kidney disease?

The most common causes are diabetes and high blood pressure, which damage the kidneys’ filters over time. Managing those conditions well is one of the best ways to protect your kidneys.

How is kidney disease detected if it has no symptoms?

With simple tests: a blood test that estimates kidney filtering (eGFR) and a urine test for protein. We screen people at higher risk, especially those with diabetes or high blood pressure, before symptoms ever appear.

Can chronic kidney disease be managed by telehealth?

Yes. Reviewing labs, adjusting medications, and follow-up visits work well by video, with in-person visits for blood and urine testing.

What insurance do you accept?

We accept Medicare and Medicaid, including the Hawaii QUEST Integration plans (AlohaCare, HMSA, Ohana Health Plan, and UnitedHealthcare Community Plan), along with most commercial insurance. We are accepting new patients in Hilo.

References

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International, 105(4S), S117–S314. https://www.kidney-international.org/article/S0085-2538(23)00766-4/fulltext

Kidney Disease: Improving Global Outcomes. (2024). CKD evaluation and management. https://kdigo.org/guidelines/ckd-evaluation-and-management/

Papa Ola Lōkahi. (n.d.). Native Hawaiian health. Retrieved June 29, 2026, from https://www.papaolalokahi.org/

This page is general health education from Ohana Care Clinic, written by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP. It is not a substitute for a personal evaluation by a qualified clinician who knows your situation, and reading it does not create a provider–patient relationship. If you think you may have a medical condition, reach out to us or another licensed provider. In an emergency, call 911.

George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner