Since the time-independent Schrödinger equation is real, is it such a surprise that the solutions should be real?
The reverse of your claim is definitely not true (at least not in general): it is perfectly possible to have real combinations of hydrogen solutions that are still degenerate. This is because energies of hydrogenoid atoms are of the form $-13.6$eV/$n^2$ and do not depend on the angular momentum $\ell$. Thus, you can take real (or complex) linear combinations such of two solutions with the same energy (i.e. same $n$) but different $\ell$ and the result will still be real (or complex). You can even arrange the angular momentum part to be real by choosing $Y_{\ell}^m(\theta,\phi)+(Y_{\ell}^m(\theta,\phi))^*$, which will again not affect the energies as they do not depend on $\ell$ or $m$. (Indeed many chemists work with "real" spherical harmonics.)
What is true is that, in a given effective potential (which would include the $\ell(\ell+1)$ term for hydrogen for instance) for fixed $\ell$, the solutions $R_{n \ell}$ and $R_{n' \ell}$ with $n'\ne n$ have different energies.
It is also true for $1d$ motion, in which case we're back to the original argument that you are solving a real differential equation so the solutions can be chosen as real. There is indeed a "non-degeneracy" theory for 1d motion in an effective potential. The proof can be found in many textbooks, such as Messiah (which I believe has the clearest proof).
Sketch of proof (if this is not plagued by typos):
Suppose $\psi\left( \xi \right)$ is solution to the
Schrodinger equation describing the $n$'th \emph{bound state }of
a system, having energy $E_{n},$ i.e. $\psi \left( \xi \right)$
is solution to the Schr"odinger equation
\begin{equation}
\frac{d^{2}}{d\xi ^{2}}\psi \left( \xi \right) +\frac{2m}{\hbar ^{2}}\left[
E_{n}-V(\xi )\right] \psi \left( \xi \right) =0.
\end{equation}
Then, there is no other function, other than multiple of $\psi \left( \xi
\right) ,$ that has this energy.
This is a proof by contradiction. Indeed assume $\psi \left( \xi \right) $
and $\phi \left( \xi \right) $ are both solutions, with $\psi \left( \xi
\right) $ $\neq c\phi \left( \xi \right) $ for an arbitrary complex constant
$c.$ Then:
\begin{equation}
\frac{1}{\psi \left( \xi \right) }\frac{d^{2}}{d\xi ^{2}}\psi \left( \xi
\right) =-\frac{2m}{\hbar ^{2}}\left[ E_{n}-V(\xi )\right] =\frac{1}{\phi
\left( \xi \right) }\frac{d^{2}}{d\xi ^{2}}\phi \left( \xi \right) ,
\end{equation}
which can be rearranged into
\begin{eqnarray}
0 &=&\phi \left( \xi \right) \frac{d^{2}}{d\xi ^{2}}\psi \left( \xi \right)
-\psi \left( \xi \right) \frac{d^{2}}{d\xi ^{2}}\phi \left( \xi \right) , \nonumber \\
&=&\frac{d}{d\xi }\left( \phi \left( \xi \right) \left( \frac{d}{d\xi }\psi
\left( \xi \right) \right) -\psi \left( \xi \right) \left( \frac{d}{d\xi }%
\phi \left( \xi \right) \right) \right) ,
\end{eqnarray}
so that
\begin{equation}
\phi \left( \xi \right) \left( \frac{d}{d\xi }\psi \left( \xi \right)
\right) -\psi \left( \xi \right) \left( \frac{d}{d\xi }\phi \left( \xi
\right) \right) =\gamma , \tag{1}
\end{equation}
where $\gamma $ is a constant.
However, for the wave functions to be normalizable, we need
\begin{equation}
\lim_{\xi \rightarrow \infty }\phi \left( \xi \right) =\lim_{\xi \rightarrow
\infty }\psi \left( \xi \right) =0.
\end{equation}
Therefore, evaluating Eqn.(1) at infinity gives $\gamma =0$ and
thus
\begin{eqnarray}
\phi \left( \xi \right) \left( \frac{d}{d\xi }\psi \left( \xi \right)
\right) &=&\psi \left( \xi \right) \left( \frac{d}{d\xi }\phi \left( \xi
\right) \right) , \\
\frac{1}{\psi \left( \xi \right) }\frac{d}{d\xi }\psi \left( \xi \right) &=&
\frac{1}{\phi \left( \xi \right) }\frac{d}{d\xi }\phi \left( \xi \right) .
\end{eqnarray}
Integrating gives $\psi \left( \xi \right) $ $=c\phi \left( \xi \right) ,$
with $c$ a constant, in contraction with the assumption that $\psi \left(
\xi \right) $ and $\phi \left( \xi \right) $ have the same energy but $\psi
\left( \xi \right) $ $\neq c\phi \left( \xi \right) .$
This shows the solution is unique up to normalization and phase. You can always choose the phase so the function is real since the function is a solution to a real differential equation.