终末期肾脏病(end stage of renal disease,ESRD)患者需要接受肾脏替代治疗，方式有血液透析、腹膜透析和肾移植3 种，需要结合其社会背景、经济状况、生活模式等选择，存在诸多涉及伦理学的问题值得深思。本文作者通过对ESRD 患者临床现状的评估、治疗进展及临床疗效概况研究，提出选择治疗方式应该遵循医学伦理学基本原则，即公正、尊重、健康指导与心理疏导结合、医术精湛与医德高尚并行，就ESRD 患者透析治疗方式的选择进行医学伦理探讨。

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,