March hemoglobinuria

March hemoglobinuria, also known as march hematuria, occurs when blood is seen in the urine after strenuous exercise, particularly affecting the feet (such as running on a hard road or Kendo) and hands (e.g. Conga drumming). The word "march" is in reference to the condition arising in soldiers who have been marching for long periods. The repetitive nature of these types of activities cause mechanical trauma to the red blood cells causing hemolysis. Free haemoglobin released from lysed red blood cells is filtered into the urine. Defects in red blood cell membrane proteins have been identified in some of these patients.