Introduction: interdialytic weight gains (IDWG) are a secondary impact of excessive fluid and/or food intake. In addition, IDWG is common in hemodialysis patients due to renal excretion dysfunction, which impacts fluid buildup. Interdialytic Weight Gain (IDWG) is a secondary impact of excessive fluid and/or food intake and is common in hemodialysis patients due to renal excretion dysfunction. If the patient has severe IDWG, it will have an impact that fluid withdrawal will be increased. This increases the risk of complications during fluid withdrawal on hemodialysis. Objective: to identify the relationship of IDWG levels with changes in blood pressure during fluid withdrawal in hemodialysis patients. Materials and Methods: this was a descriptive-analytic study in which 90 patients undergoing HD were recruited using consecutive sampling. Respondents are free to get involved and withdraw from research and respondents who are involved in research are given rewards from researchers. Result: the study found a relationship between IDWG and blood pressure changes during fluid withdrawal during the 1st hour (P value < α; α = 0.05). Discussion: blood pressure changes during hemodialysis primarily increased blood pressure influenced by some factors. The factors are IDWG levels, UF volume, stimulation of the Renin-Angiotensin-Aldosterone System, antihypertensive therapy, and history of cardiovascular disease. The limitation of this study is that blood pressure measurements on some respondents were not carried out on time, because respondents sometimes fell asleep. Conclusion: based on this study, IDWG is related to changes in blood pressure at the 1st hour of fluid withdrawal.