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1 Supplementary table 1: ICD-9 and ICD-10 codes used for the identification of major bleeding and endoscopy Bleeding episode type ICD-9 codes ICD-10 codes Intracranial 430 (Subarachnoid), 431 (intracerebral), (other and unspecified intracranial bleeding), (subdural), (unspecified intracranial bleeding) I60 (Subarachnoid), I61 (intracerebral), I62.0 (subdural), I62.1 nontraumatic extradural), I62.9 (intracranial, nontraumatic, Upper gastrointestinal (acute gastric ulcer with bleeding without obstruction), (acute gastric ulcer with bleeding and perforation without obstruction), (chronic or unspecified gastric ulcer with bleeding without obstruction), (chronic or unspecified gastric ulcer with bleeding and perforation without obstruction) (acute duodenal ulcer with bleeding without obstruction), (acute duodenal ulcer with bleeding and perforation without obstruction), (chronic or unspecified duodenal ulcer with bleeding without obstruction), (chronic or unspecified duodenal ulcer with bleeding and perforation without obstruction), (acute peptic ulcer of unspecified site with bleeding without obstruction), (acute peptic ulcer of unspecified site with bleeding and perforation without obstruction), (chronic or unspecified peptic ulcer of unspecified site with bleeding without obstruction), (chronic or unspecified peptic ulcer of unspecified site with bleeding and perforation without obstruction), (acute gastrojejunal ulcer with bleeding without obstruction), (acute gastrojejunal ulcer with bleeding and perforation without obstruction), (chronic or unspecified gastrojejunal ulcer with bleeding without obstruction), (chronic or unspecified gastrojejunal ulcer with bleeding and perforation without obstruction), (hematemesis), (blood in stool), (bleeding of gastrointestinal tract unspecified) unspecified) K92.0 (haematemesis), K92.1 (melaena), I85.0 (oesophageal varices with bleeding), I98.20 (oesophageal varices in diseases classified elsewhere with bleeding), I98.3 (Oesophageal varices with bleeding in disease classified elsewhere), K22.10 (Ulcer of oesophagus, acute with bleeding), K22.12 (Ulcer of oesophagus, acute K22.14 (Ulcer of oesophagus, chronic or unspecified with bleeding), K22.16 (Ulcer of oesophagus, chronic or unspecified K25.0 (Gastric ulcer, acute with bleeding), K25.2 (Gastric ulcer, acute K25.4 (Gastric ulcer, chronic or unspecified with bleeding), K25.6 (Gastric ulcer, chronic or unspecified K26.0 (Duodenal ulcer, acute with bleeding), K26.2 (Duodenal ulcer, acute with both bleeding and perforation), K26.4 (Duodenal ulcer, chronic or unspecified with bleeding), K26.6 (Duodenal ulcer, chronic or unspecified with both bleeding and perforation), K27.0 (Peptic ulcer, acute with bleeding), K27.2 (Peptic ulcer, acute with both bleeding and perforation), K27.4 (Peptic ulcer, chronic or unspecified with bleeding), K27.6 (Peptic ulcer, chronic or unspecified K28.0 (Gastrojejunal ulcer, acute with bleeding), K28.2 (Gastrojejunal

2 ulcer, acute with both bleeding and perforation), K28.4 (Gastrojejunal ulcer, chronic or unspecified with bleeding), K28.6 (Gastrojejunal ulcer, chronic or unspecified with both bleeding and perforation), K29.0 (Acute bleeding gastritis), K63.80 (Angiodysplasia of small intestine, except duodenum with bleeding), K31.80 (Angiodysplasia of stomach and duodenum with bleeding) Lower gastrointestinal (bleeding of rectum and anus), K55.20 (Angiodysplasia of colon with bleeding), K62.5 (bleeding of anus and rectum), K92.2 (Gastrointestinal bleeding, unspecified) Other bleeding (other unspecified hemorrhagic conditions), (unspecified hemorrhagic conditions), (bleeding into bladder wall), (bleeding from throat), (hematuria, unspecified), (postmenopausal bleeding), (bleeding unspecified), (hemarthrosis site unspecified), N02.0 (Recurrent and persistent haematuria, minor glomerular abnormality), N02.1 (Recurrent and persistent haematuria, focal and segmental glomerular lesions), N02.2 diffuse membranous glomerulonephritis), N02.3 diffuse mesangial proliferative glomerulonephritis), N02.4 (Recurrent and persistent haematuria, diffuse endocapillary proliferative glomerulonephritis), N02.5 (Recurrent and persistent haematuria, diffuse mesangiocapillary glomerulonephritis), N02.6 dense deposit disease), N02.7 diffuse crescentic glomerulonephritis), (hemoptysis, unspecified) N02.8 (Recurrent and persistent haematuria, other), N02.9 (Recurrent and persistent haematuria, unspecified), K66.1 (Haemoperitoneum), N93.8 (Other specified abnormal uterine and vaginal bleeding), N93.9 (Abnormal uterine and vaginal bleeding, unspecified), N95.0 (Postmenopausal bleeding), R04.1 (bleeding from throat), R04.2 (Haemoptysis), R04.8 (bleeding from other sites in respiratory passages), R04.9 (bleeding from respiratory passages, unspecified), R31.0 (Gross hematuria), R31.1 (Microscopic hematuria), R31.8 (Other and unspecified hematuria), R58 (bleeding, not

3 Endoscopy CCP: 0112, 0112A, 0114, 0116A, 0116B, 0116C, 0122, 0122A, 0122B, 0122C, 0124A, 0124B, 0124BA, 0124BB, 56341, 56391, 5651 elsewhere classified), D68.3 (Haemorrhagic disorder due to circulating anticoagulants), H35.6 (Retinal bleeding), H43.1 (Vitreous bleeding), H45.0 (Vitreous bleeding in diseases classified elsewhere), M25.0 (Haemarthrosis) CCI: 1NA13BAGX, 1NA13BAKK, 1NF13BA, 1NF13BAAG, 1NF13BABD, 1NF13BAC2, 1NF13BAFA, 1NF13BAGX, 1NF13BAKK, 1NF13BAW4, 1NF13BAX7, 1NF80BA, 1NK50BANR, 1NP13BAC2, 1NP13BAGN, 1NP13BAGX, 1NP13BAKK, 1NQ13BAGX, 1NQ13BAKK, 1NQ13CAC2, 1NQ13CAGN, 2NF70BA, 2NF70BN, 2NF71BA, 2NF71BP, 2NF71BR, 2NK70BABJ, 2NK70BABL, 2NK70BCBK, 2NK70BDBK, 2NK70BNBJ, 2NK70BNBL, 2NK71BABJ, 2NK71BABL, 2NK71BRBJ, 2NK71BRBL, 2NM70BABG, 2NM70BABH, 2NM70BABJ, 2NM70BNBG, 2NM70BNBH, 2NM71BABG, 2NM71BABH, 2NM71BABJ, 2NM71BRBG, 2NM71BRBJ, 2NQ70BA, 2NQ70CA, 2NQ71BA, 2NQ71BR, 2NQ71CA, 2NT70BA, 2NT70JA, 2NT71BA

4 Supplementary table 2 Baseline characteristics of participants excluded from the study based on the lack of an outpatient serum creatinine measurement Variables Overall study cohort No outpatient serum creatinine n=12403 n=2742 p-value Females (%) Age (mean; SD) 77.7 (7.0) 77.7 (7.7) First Nations status (%) Hypertension (%) Diabetes (%) Charlson comorbidities Cancer <0.001 Cerebrovascular disease Congestive heart failure <0.001 Chronic obstructive pulmonary disease Dementia Metastatic solid tumour Myocardial infarction <0.001 Mild liver disease Moderate or severe liver disease Paralysis <0.001 Peptic ulcer disease Peripheral vascular disease <0.001 Rheumatic disease <0.001 Previous admission to hospital for hemorrhage CHADS 2 score (%) Proteinuria (%) <0.001 Normal <0.001

5 Drug use Region (n, %) Income quintiles Mild Heavy Not measured Antiplatelet agents NSAIDs PPIs <0.001 Rural Urban <0.001 Unknown Unknown Supplementary figure 1 Kaplan-Meier curves showing the cumulative incidence of major bleeding according to egfr categories

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