Identity and Wisdom as Elements of a Spirituality of Hope among Children with End-stage Renal Disease

This article explores hope as a spiritual resource among children with end-stage renal disease, situating their experiences within broader theological and pastoral discourses. While recent theologies of hope—grounded in Pauline literature and eschatological frameworks—primarily emphasize adult existential concerns, little attention has been given to children’s own accounts of hopefulness. Drawing on qualitative research with twelve children aged 9–19, the study develops a preliminary theological model of hope that is contextual, relational, and conative. Five pathways to hope are identified—maintaining identity, real/izing connections, claiming power, attending to God, and learning wisdom—each shaped by the interplay of illness, interdisciplinary care teams, and experiences of suffering. Unlike dominant future-oriented theologies, children describe hope as present and participatory, manifesting in daily relationships, immediate abundance, and embodied practices of resilience. Their accounts challenge eschatologies centered on deferred fulfillment and Christological abstraction, suggesting instead a lived, sapiential eschatology rooted in ordinary grace and community. The article concludes by reflecting on implications for pastoral, clinical, and community practice, highlighting the need for intentional, relational strategies to nurture hope in chronically ill children as both a spiritual and medical resource.