Blood work shows bilirubin at 1.9mg/dl (direct 0.4mg/dl) creatine kinase of 421 u/l. urinalysis shows micr hematuria 5-10 rbc/hpf. what could it be?

Need more info.,,: It would be best to get more tests/info. Before deciding exactly what this is. It looks like there is a red cell destruction process going on from the bilirubin breakdown, but the hematuria and ck result could mean kidney and/or muscle injury. So it'd be wise to see your doctor soon to get more tests if you haven't had them to be sure. Best of luck.