Abstract: Patients with end stage renal disease (ESRD) are treated with one of the three kidney replacement therapies, hemodialysis, peritoneal dialysis and kidney transplantation. Social background, economic condition and living style should be considered in the modality selection of kidney replacement therapies. Medical ethics involved in the selection need to be investigated. Based on the clinical evaluation of ESRD patients, treatment progress, and the results of therapeutic efficacy studies, the author suggests in this paper that the fundamental principles of medical ethics including justice, respect, health guidance combined with psychological counseling, best medical skills and ethics are the rules necessarily for the modality selection,

Key words: End stage renal disease, Kidney replacement treatment, Medical ethics