Hypouricemia in Chinese Secondary Hospital Inpatients: A Retrospective Study on Prevalence and Determinants

Purpose: Data on hypouricemia in inpatients in Chinese secondary hospitals are still limited, which hinders precision management in primary care. This study examined its prevalence, correlates, and clinical features to provide evidence for better clinical decision making. Patients and Methods: This retrospective study included 17541 adult inpatients at the Fusui County People's Hospital (Guangxi, China) in 2024. Patients were categorized as having hypouricemia (n=234 patients), normouricemia (n=14,468) or hyperuricemia (n=2,839). Stratified analyses according to sex, age, eGFR and BUN were performed, and FLR was used to identify associated factors. Results: The prevalence of hypouricemia was 1.33%, which was significantly greater in females (1.72%) than in males (0.87%, P<0.001). Hypouricemic patients had higher eGFRs and lower BUN/creatinine ratios than the other patients did. The prevalence increased with age to a maximum of 60--79 years and then decreased, with females consistently outnumbered males. Regression analysis revealed that female sex (OR=1.50), old age (45--59 years: OR=3.00; 60--79 years: OR=5.96; ≥80 years: OR=10.90), low BUN levels (<3.38 mmol/L, OR=3.95) and high eGFRs (≥90 mL/min/1.73 m ² , OR=2.45) were independent risk factors. The most common associated conditions were inflammatory, intracranial and liver diseases and type 2 diabetes. Conclusion: Hypouricemia tends to occur more frequently in female inpatients and is associated with age, high eGFR and low BUN, indicating the importance of malnutrition and increased renal clearance.