Gradual peritoneal dialysis (PD) is suitable for patients with better residual renal function. At the initial period, lower than the “full dose” dialysis combined with an appropriate protein diet and water and salt restriction were adopted to achieve the clearance of solute and fluid by both the residual renal and peritoneum. As the residual renal function changes with time, dialysis dose and ultrafiltration volume must be regulated gradually to maintain adequate clearance of solute and fluid. Gradual PD has the advantages of delayed loss of residual renal function, less complications, less medical expenses, and higher quality of life, as compared with the routine PD method. However, whether gradual PD leads to better clinical outcome remains to be identified. The suitable patients for this treatment profile, the schedule of PD dose adjustment, compliance of the patients and safety of gradual PD are yet controversial.