An optical blood monitoring system with a ratiometric model determines hematocrit values for a hemodialysis patient, from which hemoglobin values for the patient are estimated. The ratiometric model is calibrated, normally against a cell counter, using blood from a blood bank. The blood from a blood bank is preserved in a long term preservative which is typically different than that found in clinical settings. The hematocrit value determined by the ratiometric model is scaled by scaling factor so that the estimated hemoglobin level output from the monitor consistently matches that measured in a clinical setting. The hematocrit scaling factor is substantially about 1.033 when the patient's blood sample is stored in a short term preservative ethylene diamine tetra acetic, and is substantially about 1.06 when the hematocrit is measured in the blood sample without preservative being added to the blood sample. The hemoglobin value can also be adjusted for altitude.
