Abstract Background and Aims Interdialytic weight gain (IDWG) is one of the most important indicators of the patient status in chronic hemodialysis: it is correlated with fluid and/or food intake and it is assessed at the beginning of the dialysis session being an easily measurable parameter. High IDWG is associated with risk of all-causes mortality and hospitalization; furthermore, high IDWG leads to supplementary dialysis sessions with consequent reduction of the quality of life and increase of the costs. Numerous barriers have been shown to determine failure to adherence to diet and fluid restrictions such as lack of self-assessment. The present systematic review and meta-analysis tries to determine the differences in the IDGW between low salt diet and normal/high salt diet, and between nutritional counseling aimed at reducing salt intake and no nutritional counseling in patients on chronic hemodialysis. Method Medline, PubMed, Web of Science, and the Cochrane Library were searched for studies comparing subjects who experienced educational or psychological interventions to untreated control patients. Outcome of interest was IDWG. Results Eight articles (783 patients) were fully assessed for eligibility and included in the investigation. The meta-analysis showed patients that after dialysis increased their weight more than 2.5 Kg over total enrolled subjects for each group (control and experimental). As no significant heterogeneity was observed (I2 =8%; p=0.36), the pooled analysis was performed using a fixed-effect model. Funnel plot was generated and no obvious asymmetry was observed, which indicates no clear evidence of publication bias. The Overall Odds Ratio to get an event in the experimental group, in respect to controls, is 0.57 (0.33-0.97) (p=0.04] with single studies OR ranging between 0.11 to 1.08, the last derived by a peculiar result reported in the Sevick's manuscript referring an identical IDGW of 1.1 Kg for both groups and an extremely narrow IQ range (1.0-1.2); therefore, in this case, the estimated number of events (patients with IDGW > 2.5 Kg) was rounded up to 1. Conclusion The present systematic review and meta-analysis suggest that the use of a low salt diet and/or a nutritional counseling aimed at reducing salt intake are associated with a statistically significant reduction of the IDWG in patients on chronic hemodialysis.