Although Jaffes name is synonymous with clinical creatinine testing, his paper only described the principle behind what would later become the enduring method. It was Otto Folin (1867–1934), a Harvard biochemist, who adapted Jaffes research—abandoning the standard Neubauer reaction of the time—and published several papers using the Jaffe reaction to analyze creatinine levels in both blood and urine. Folin began using the picric acid procedure in 1901 and included it in his 1916 Lab Manual of Biological Chemistry. During his career, Folin modified and improved several quantitative colorimetric procedures, the first of which was for creatinine. He took advantage of technology available at the time, using a Duboscq colorimeter for measurement precision, and is credited for introducing colorimetry into modern biochemical analysis.
Folin's research did not focus on creatinine as a renal function indicator. Since the precursors of creatinine are synthesized in the liver, at this point in history, creatinine was considered indicative of liver function. It was not until 1926 that Poul Kristian Brandt Rehberg suggested creatinine was a significant marker for renal function.