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Background: The increasing incidence of chronic kidney disease (CKD) globally highlights the importance of early targeted screening of at-risk persons in primary healthcare settings. This study investigated the early detection of CKD among Aboriginal and Torres Strait Islander patients attending an urban primary healthcare service. Methods: Routine data extracted for all patients with an active electronic medical record on 7 December 2017 were used to identify patients who were eligible to have a kidney health check (KHC), comprising estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR) tests. A subsequent manual search of electronic health records identified the presence of CKD risk factors and follow-up KHCs. Results: Of the 1181 eligible patients, 171 (15%) had a complete initial KHC. Of the eight patients with an initial abnormal eGFR, two (25%) had a repeat eGFR assessment within 3 months to confirm the presence of CKD. Of the 30 patients who had an initial abnormal UACR result, three (10%) had at least one repeat UACR measurement within 3 months. In patients with diabetes and/or hypertension and a normal initial KHC, 51% had a repeat eGFR and 36% had UACR within the recommended time frame of 12 months. Similar findings were observed for the recommended time frame of 24 months in patients without diabetes or hypertension. Conclusion: Accurate documentation of risk factors for CKD and processes to address the barriers to implementation of Kidney Health Australia guidelines will assist in preventing or delaying progression of CKD. The incidence of CKD is increasing globally and in Australia, with the condition affecting approximately one in five Aboriginal and Torres Strait Islander peoples. This study investigated the early detection of CKD among Aboriginal and Torres Strait Islander patients attending an urban Aboriginal and Torres Strait Islander primary healthcare service and found that some patients did not have the kidney health checks according to national guideline recommendations. Addressing the challenges in early detection of CKD are essential for preventing or delaying its progression. [ABSTRACT FROM AUTHOR]