Rifampicin and isoniazid behave as non-creatinine chromogens and interfere with Jaffe's reaction: A phenomenon with the potential to give a false-positive result in creatinine estimation.

Tuberculosis is a health concern worldwide. The anti-tubercular drugs (particularly rifampicin) used for its management offers side effects like acute kidney injury. Creatinine, which is recognised as an important biomarker for the renal function, is commonly estimated with Jaffe's reaction (alkaline picrate reaction). However, interference of Jaffe's reaction with non-creatinine chromogens has been reported. In this context, we have checked the possibility of interference by Rifampicin and Isoniazid at therapeutic concentration with the Jaffe's reaction. Through in-silico study, we have studied the reaction prediction of picric acid with other chemicals/reactant (i.e. Rifampicin, Isoniazid and non-creatinine chromogens) in terms of confidence value. It is observed that the confidence value of reaction prediction between picric acid and INH and Rifampicin is much more than the same of pyruvic acid (non-creatinine chromogen). Further, we have checked the absorbance value of Jaffe's reaction mixture in aqueous media in the presence of both the drugs at 520nm. It is observed that the absorbance of alkaline picric acid increases with an increase in drug concentration. However, the increasing trend of absorbance is much more in the case of rifampicin compared to INH. It appears from our result rifampicin, and isoniazid has the potential to behave as non-creatinine chromogen and can give false positive creatinine results in Jaffe's reaction. Thus, it can cause misdiagnosis in patients consuming these drugs. We recommend study in the biological matrix for further validation of the result.