The "Expert Consensus on the Selection of Blood Purification Modalities" was first published in 2019. After six years of accumulating evidence-based medical updates and clinical practice validation, and to accommodate advancements in blood purification technology and evolving diagnostic and treatment standards, a comprehensively revised edition is now formally released. This updated consensus, authored by 39 nephrology and blood purification experts, integrates evidence-based medicine and clinical experience to propose 26 recommendations providing guidance for selecting blood purification modalities. It     covers the assessment of hemodialysis adequacy and details the indications, advantages, limitations, and precautions for various commonly used blood purification modalities, including low-efficiency hemodialysis, low-flux hemodialysis, high-flux hemodialysis, hemodiafiltration, hemofiltration, isolated ultrafiltration, and hemoadsorption. This consensus offers comprehensive and systematic guidance for blood purification practitioners, aiming to further standardize hemodialysis management, enhance quality control, and improve long-term patient outcomes.