President Tito, kept alive by a kidney machine and suffering increasing internal bleeding, took a turn for the worse today, and officials appeared doubtful that the 87-year-old leader would survive much longer.

In its most pessimistic report in more than three weeks, Tito's eight-man medical team said his condition had become "very grave" -- a significant change from the "grave but stable" of the last few days.

Official sources said Tito came close to death last night for the fifth time since his left leg was amputated seven weeks ago.

Since that operation, Tito became afflicted with serious kidney problems requiring constant dialysis treatment, a steadily weakening heart and a tendency for spontaneous bleeding, his doctors said.

The latest medical bulletin, issued by the doctors treating the president in this northern city, said without elaboration: "The general state of health of President of the Republic Josip Broz Tito is very grave. The grave insufficiency of the kidneys continues.

"The use of an artificial kidney is continuing. The general tendency to spontaneous bleeding is more evident. The weakness of the heart remains. Necessary measures of intensive treatment are being taken."

President Tito's leg was amputated Jan. 20 after the failure of a bypass operation to ease artery blockage, and the onset of gangrene, which threatened his life.

He seemed to be making a remarkably fast recovery until Feb. 10, when a steep decline set in. He began suffering kidney failure, digestive problems, heart weakness, cardiac disturbances and then pneumonia.

The use of the phrase "very grave" was the first since Feb. 14, when official sources said he appeared to be close to death in the intensive care unit of the ultramodern Clinical Center here.

For more than two weeks, doctors have used a dialysis machine to support the kidney functions and filter out toxic substances from the bloodstream. Tito's kidneys have almost entirely failed.

Medical sources said the internal bleeding involved the bursting of capillaries, or small blood vessels, in his lungs. This seemed to be caused by pneumonia and kidney failure.

On Tuesday, the doctors said there were signs that the pneumonia was starting to subside.

President Tito, a tough World War II partisan leader, has ruled this Balkan country for nearly four decades and is chief of both the state and the Communist Party for life.