From the Research
Hypouricemia can be caused by several factors, including certain medications, liver disease, genetic conditions, and kidney disorders, as evidenced by the most recent study in 2025 1. The causes of hypouricemia can be categorized into several groups, including:
- Medications: certain medications such as allopurinol, febuxostat, and uricosuric drugs like probenecid and sulfinpyrazone can lower uric acid levels, as well as SGLT2 inhibitors and high-dose aspirin.
- Liver disease: severe hepatocellular disease can lead to hypouricemia.
- Genetic conditions: inherited metabolic defects in purine metabolism, such as hereditary xanthinuria, and defects in urate transporters like URAT1/SLC22A12 and GLUT9/SLC2A9 can cause hypouricemia.
- Kidney disorders: renal hypouricemia can be caused by URAT1 or GLUT9 loss-of-function mutations, and Fanconi syndrome can also lead to hypouricemia. Other factors that can contribute to hypouricemia include malnutrition, particularly protein deficiency, overhydration, and excessive vitamin C intake. It is essential to identify the underlying cause of hypouricemia, as very low uric acid levels can occasionally lead to complications like exercise-induced acute kidney injury, as noted in a study from 2022 2. A healthcare provider should be consulted to determine the cause of unexplained low uric acid levels and to decide if any intervention is necessary, taking into account the potential risks and benefits of treatment, as discussed in a study from 2024 3.