Objective To verify the effect of IoT technology based management system on water and nutrition management in maintenance hemodialysis （MHD） patients. Methods A total of 102 MHD patients were divided into two groups according to their dialysis date, with 51 cases in each group. The control group was given routine management, while the experimental group received mana-gement by utilizing an IOT based management system. The effect was evaluated 6 months after the intervention. Results The total scores of the Renal Adherence Attitudes Questionnaire and the Renal Adherence Behavior Questionnaire, mid-arm muscle circumference, serum albumin and hemoglobin were significantly higher, whereas interdialysis weight gain (IDWG), percentage of IDWG, and score of Modified Quantitative Subjective Global Assessment of Nutrition were significantly lower in the experimental group compared with the control group (P<0.05, P<0.01).Conclusion The IoT based management system can enhance compliance of MHD patients with diet and fluid intake, thus to improve management effect and relevant nutritional indicators.