To provide a compound useful as an active ingredient of a pharmaceutical composition, e.g., a pharmaceutical composition for the treatment of chronic renal failure and/or diabetic nephropathy. The inventors conducted in-depth studies of compounds having an EP4 receptor-antagonizing effect, discovered an amide compound or salt thereof having an EP4 receptor-antagonizing effect, and perfected the present invention. The amide compound or salt thereof has an EP4 receptor-antagonizing effect and can be used as an active ingredient of a pharmaceutical composition for the prevention and/or treatment of various diseases in which EP4 is involved, e.g., chronic renal failure and/or diabetic nephropathy.本發明提供一種作為醫藥組成物，例如慢性腎衰竭(renal failure)及/或糖尿病性腎病之治療用之醫藥組成物之有效成分而有用之化合物。本發明人等針對具有EP4受體拮抗作用之化合物積極檢討，發現醯胺化合物或其鹽具有EP4受體拮抗作用，而完成本發明。醯胺化合物或其鹽具有EP4受體拮抗作用，可使用作為EP4所參與之各種疾病，例如慢性腎衰竭及/或糖尿病性腎病之預防及/或治療用醫藥組成物之有效成分。
