hard to answer your question because its so vague.
generally a fever higher than 101 with unexplained pain would send me there.

I would call the neph. that knows your latest lab work numbers and ask the nurse to ask him if you should go to ER. You may need medication to help with the nausea so you can stop throwing up so you can prevent dehydration. What do you mean you don't feel the pain like most people? Is it a general sick/nausea/dizzy feeling. I get this when I am dehydrated or overworked. My gfr is still >60. Where is your gfr at now?
To help with my nausea/dizziness my doc prescribed Promethazine 12.5 mg tablets and one usually does the trick. Sometimes I feel more dizzy than nauseous so I have also prescribed Meclizine 12.5 mg. Talk to your doctor today about your present symptoms and get him to prescribe you something so you don't have to go to the ER for these episodes. He should ask you questions to make sure that you needn't go to ER or if you should. How high does your BP get and are you dehydrated would be my questions but please call your doc today. He is the best person to ask. Let us know how you do. I hope you can get this resolved quickly.
Jessica

Back in April I got a stomach flu and couldn't stop vomiting so I knew I was dehydrated so I went to ER. After an IV to hydrate me and meds for nausea I was better. The ER doc gave me prescription for Ondansetron 4 mg. ODT (dissolves under the tongue) as a substitute for Zofran which I used to take.
Everyone is different with pkd but I do remember my Mom going into dialysis phase being nauseous and taking something for it. I don't have pain. When I ruptured 3 cysts-yes-that was excruciating pain-no doubt about it-go to ER. Fever, sudden onset of unrelenting pain, elevated BP that won't go down and unrelenting vomiting would send me to ER. Let us know how you do with doc-don't be afraid to ask him all your questions.
Jessica

Thank you all so much. I have phenegren, I think that's what it is, for the nausea but I didn't have it with me. I have kidney stones as well and it was a kidney stone passing. I see my primary tomorrow and will talk to him about the meds listed in the replies here. In May I just started throwing up, felt the same way I did yesterday and went to ER after 5 hours. By that time my bp was so high it was doing something to my heart and I got admitted to ICU, ended up having endo surgery to remove stone after they got the bp under control. That episode was so different from all my other kidney stone episodes cuz I felt no pain as I did all other times. I have never had a fever when my cysts burst; debilitating pain for short duration (compared to the stone passing) or just blood in my urine. It's so unpredictible and every situation is so different I didn't know what to do. I'm noticing that I get confused and don't think clearly when I get so fatigued because it was a pretty no brainer situation - yet I didn't know. Is this what I can expect?

You need to treat any occassions of ill health with caution espescially if they are not normal for you. I know appointments ER visits , hospital admissions get us all down but you have to look after your body and dont just think you can sleep it off. My aunty is a dialysis patient and did that recently and for two weeks felt ill but sought no medical help. She finally got admitted and had a very severe liver and kidney infection and has had to have 8 blood transfusions due to the critical state she was in. She is still not back on her feet yet and she has learned her lesson by realising she cannot sleep these things off. Please go to ER if you don't feel well. Let them be the judge of whether it is something that can be treated quickly or needs a hospital admission